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MINNESOTA VALLEY HEALTH CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MINNESOTA VALLEY HEALTH CENTER INC (EIN 41-0837659)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-06
IRS object ID
201301269349300635
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-06T10:03:16-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN410837659EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Minnesota Valley Health Center IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% PAT SCHLEGELInCareOfName
Name ControlMINNNameControl
Phone5076653375Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1621 South 4th StreetAddressLine1
CityLe SueurCity
StateMNState
ZIP Code56058ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePatricia SchlegelName
TitleCFOTitle
Date Signed2013-05-03DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPatricia TownsdinNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1621 SOUTH 4TH STREETAddressLine1
CityLe SueurCity
StateMNState
ZIP Code56058ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12608554GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.essentiahealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1959YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionOur mission is to provide community-based healthcare in an environment that fosters dignity, respect and excellence.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees205TotalNbrEmployees
Total Nbr Volunteers56TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year102068ContributionsGrantsPriorYear
Contributions Grants Current Year92542ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11301433ProgramServiceRevenuePriorYear
Program Service Revenue CY12365395ProgramServiceRevenueCY
Investment Income Prior Year22251InvestmentIncomePriorYear
Investment Income Current Year16841InvestmentIncomeCurrentYear
Other Revenue Prior Year106741OtherRevenuePriorYear
Other Revenue Current Year132183OtherRevenueCurrentYear
Total Revenue Prior Year11532493TotalRevenuePriorYear
Total Revenue Current Year12606961TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year13847GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY7080GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5949046SalariesEtcPriorYear
Salaries Etc Current Year6199595SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4920510OtherExpensePriorYear
Other Expenses Current Year5723280OtherExpensesCurrentYear
Total Expenses Prior Year10883403TotalExpensesPriorYear
Total Expenses Current Year11929955TotalExpensesCurrentYear
Revenues Less Expenses Prior Year649090RevenuesLessExpensesPriorYear
Revenues Less Expenses CY677006RevenuesLessExpensesCY
Total Assets BOY13330186TotalAssetsBOY
Total Assets EOY13844447TotalAssetsEOY
Total Liabilities BOY8932534TotalLiabilitiesBOY
Total Liabilities EOY8579584TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4397652NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5264863NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOur mission is to provide community-based healthcare in an environment that fosters dignity, respect and excellence.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense10396865Expense
Grants7080Grants
Revenue12405064Revenue
DescriptionSee Schedule ODescription
Total Program Service Expense10396865TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees205NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteesfalseMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPAT SCHLEGELNamePerson
Telephone Number5076653375TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1621 SOUTH 4TH STREETAddressLine1
CityLe SueurCity
StateMNState
ZIP Code56058ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
RANDY BAUM
BOARD PRESIDENT10.0XX000
KEITH MAETZOLD
BOARD VICE PRES THRU 4/125.0XX000
ROBERT BROEDER
BOARD SECRETARY/TREASURER5.0XX000
JOHN SKUBITZ
BOARD DIRECTOR1.0X000
STEVE SMITH
BOARD DIRECTOR1.0X000
JOSEPH SPINLER
BOARD DIRECTOR1.0X000
MICHAEL HEDRIX
BOARD DIRECTOR60.0X035385288322
PATRICIA TOWNSDIN
President60.0X012516930802
PATRICIA SCHLEGEL
Chief Financial Officer50.0X74066010771
FieldValueIRS element (for citing)
Total Reportable Comp From Org74066TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs479021TotalReportableCompFrmRltdOrgs
Total Other Compensation129895TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WAPITI MEDICAL GROUP
PO BOX 92NEWELLSD57760ER PHYSICIAN SRVS731755
AEGIS THERAPIES INC
PO BOX 8103FORT SMITHAR72902PHYSICAL THERAPY519825
OMNICARE PHARMACY
PO BOX 715268COLUMBUSOH43271PHARMACY SERVICES264794
CENTRAL MINNESOTA DIAGNOSTIC INC
PO BOX 158MILACAMN56353CT SCAN SERVICES185400
UNIVERSAL HOSPITAL SERVICES
SDS-12-0940 PO BOX 86MINNEAPOLISMN55486MEDICAL EQUIP MAINT117478
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants8280GovernmentGrants
All Other Contributions84262AllOtherContributions
Total Contributions92542TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column12365395TotalRevenueColumn
Related Or Exempt Function Income12365395RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue12365395TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column18434TotalRevenueColumn
Exclusion$18,434ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real39905Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real39905Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column39905TotalRevenueColumn
Exclusion$39,905ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities836Securities
Other757Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-836Securities
Other-757Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1593TotalRevenueColumn
Exclusion-$1,593ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
DIETARY/VENDING INCOME72221040577$40,577
CMDI EQUITY PAYMENT9000993966939669
TELEPHONE INCOME9000995655$5,655

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column6377TotalRevenueColumn
Exclusion$6,377ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue92278TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12606961TotalRevenueColumn
Related Or Exempt Function Income12405064RelatedOrExemptFunctionIncome
Exclusion$109,355ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total7080Total
Program Services7080ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total208834Total
Management And General208834ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4739028Total
Program Services4101301ProgramServices
Management And General637727ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total75788Total
Program Services20308ProgramServices
Management And General55480ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total831495Total
Program Services707602ProgramServices
Management And General123893ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total344450Total
Program Services291192ProgramServices
Management And General53258ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total120Total
Management And General120ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total57083Total
Management And General57083ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total86Total
Management And General86ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total890Total
Management And General890ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2203606Total
Program Services2203606ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total46360Total
Management And General46360ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total143051Total
Program Services89958ProgramServices
Management And General53093ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total171250Total
Program Services166112ProgramServices
Management And General5138ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total269394Total
Program Services261066ProgramServices
Management And General8328ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total31625Total
Program Services22338ProgramServices
Management And General9287ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total388344Total
Program Services388344ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total586198Total
Program Services586198ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total90300Total
Program Services90300ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL/DIETARY SUPPLIES645723645723
AFFILIATE SUPPORT FEE262616262616
DHS SURCHARGES-NH & HOSPITAL260387260387
BAD DEBT EXPENSE248000248000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total318247Total
Program Services307350ProgramServices
Management And General10897ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11929955Total
Program Services10396865ProgramServices
Management And General1533090ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY184763BOY
EOY407827EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2174389BOY
EOY2825307EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY155174EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1362840BOY
EOY1596997EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1465571BOY
EOY191716EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY91458BOY
EOY101295EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY50653BOY
EOY48917EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis12503838LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4990265LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7156811BOY
EOY7513573EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY115135BOY
EOY111918EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY728566BOY
EOY891723EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY13330186BOY
EOY13844447EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1372089BOY
EOY1378420EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY33707BOY
EOY31191EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY7466887BOY
EOY7169973EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY59851BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8932534BOY
EOY8579584EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3693923BOY
EOY4343670EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY35014BOY
EOY287979EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY668715BOY
EOY633214EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4397652BOY
EOY5264863EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13330186BOY
EOY13844447EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses677006ReconcilationRevenueExpenses
Reconcilation Other Changes190205ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$86OtherActivitiesAmount
Total Lobbying Expenditures IIB86TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSchedule C, Part II-BIdentifier
ExplanationLobbying Activity Explanation: Minnesota Valley Health Center, Inc. pays dues to a certain organization related to the industry which has lobbying expenses. The amount listed is the percentage of the dues paid that were used for lobbying.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1239680OtherCostOrOtherBasis
Depreciation822705Depreciation
Book Value416975BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5696866OtherCostOrOtherBasis
Depreciation49711Depreciation
Book Value5647155BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5324036OtherCostOrOtherBasis
Depreciation4064146Depreciation
Book Value1259890BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis243256OtherCostOrOtherBasis
Depreciation53703Depreciation
Book Value189553BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7513573TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionBENEFICIAL INTEREST IN MN FDNDescription
Book Value891723BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets891723TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Total Revenue12606961TotalRevenue
Total Expenses11929955TotalExpenses
Excess Or Deficit For Year677006ExcessOrDeficitForYear
Net Unrealized GL On Investments-5884NetUnrealizedGLOnInvestments
Other$196,089OtherAmount
Total Adjustments190205TotalAdjustments
Excess Or Deficit Per FS867211ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12579702TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-5884NetUnrealizedGainsInvestments
Revenue Not Rptd F990-5884RevenueNotRptdF990
Revenue Subtotal12585586RevenueSubtotal
Other Revenues Not Included21375OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt21375RevenueNotRptdOnFinStmt
Total Revenue Per Form99012606961TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt11929955TotExpensesEtcAuditedFinclStmt
Expenses Subtotal11929955ExpensesSubtotal
Total Expenses Per Form99011929955TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierExplanationExplanation
Schedule D, Part IV, Line 2BMinnesota Valley Health Center, Inc. acts as custodian for the funds of the residents. Resident trust funds totaled $16,463 at June 30, 2012. During that same time Minnesota Valley Health Center, Inc. holds $14,728 in a separate account for tenant security deposits for Sunrise Plaza.
Schedule D, Part XASC 740 footnote: Essentia Health has adopted Accounting Standards Codification 740, Income Taxes (formerly known as FASB Interpretation No. 48 (FIN 48), Accounting for Uncertainty in Income Tax - an interpretation of FASB Statement No. 109, Accounting for Income Taxes). The adoption of this interpretation had no material impact on the consolidated financial statements and therefore, Essentia Health's consolidated financial statements for fiscal year ended June 30, 2012 no longer includes an ASC 740 footnote.
Schedule D, Part XI, Line 8Other Changes in net assets: Change in beneficial interest of Minnesota Foundation: $196,089 Schedule D, Part XII, Line 4b Other Changes in Revenue: Restricted Grants & Contributions: $20,100 Restricted interest income: $1,275

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served67PersonsServed
Total Community Benefit Expense21972TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense21972NetCommunityBenefitExpense
Percent Of Total Expense0.00190PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served957PersonsServed
Total Community Benefit Expense1729398TotalCommunityBenefitExpense
Direct Offsetting Revenue2093539DirectOffsettingRevenue
Net Community Benefit Expense-364141NetCommunityBenefitExpense
Percent Of Total Expense0.03120PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served1024PersonsServed
Total Community Benefit Expense1751370TotalCommunityBenefitExpense
Direct Offsetting Revenue2093539DirectOffsettingRevenue
Net Community Benefit Expense-342169NetCommunityBenefitExpense
Percent Of Total Expense0.02930PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served102PersonsServed
Total Community Benefit Expense6682TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense6682NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served410PersonsServed
Total Community Benefit Expense21607TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense21607NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served512PersonsServed
Total Community Benefit Expense28289TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense28289NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served1536PersonsServed
Total Community Benefit Expense1779659TotalCommunityBenefitExpense
Direct Offsetting Revenue2093539DirectOffsettingRevenue
Net Community Benefit Expense-313880NetCommunityBenefitExpense
Percent Of Total Expense0.02690PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$248,000BadDebtExpenseAmount
Amount Attributable To550AmountAttributableTo
Amount Reimbursed By Medicare2467375AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare2442946CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall24429MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Minnesota Valley Health CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1621 South 4th StreetAddressLine1
CityLe SueurCity
StateMNState
ZIP Code56058ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Minnesota Valley Health CenterBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent150.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
SunriZe Plaza
600 South 5th StreetLe SueurMN56058Independent Living Facility
Gardenview Nursing Home
621 South 4th StreetLe SueurMN56058Nursing Home

Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)

IdentifierIdentifierExplanationExplanation
SCHEDULE H, Part VI, line 2Provide the description required for Part I, lines 3c, 6a, 7g, 7, column (f), 7; Part II; Part III, lines 4, 8, 9b; Part V, lines 1j, 3, 4, 5c, 6i, 7, 11h, 13g, 15e, 16e, 18c, 18d, 19d, 20, 21: Part I, Line 3c In addition to the federal poverty guidelines for income, an asset test is also applied. For these purposes, household assets include: Cash held in savings accounts, checking accounts, safe deposit boxes, or homes; Value of trusts (including living trusts) the patient or guarantor has interest or ownership of equity in real estate; Cash value of stocks, bonds, treasury bills, certificates of deposit and money market accounts; Cash value of life insurance policies; Personal property held as an investment, such as jewelry, coin collections, Vehicles other than an automobile of reasonable value used as the primary source of transportation; and Lump sum or one-time receipts of funds, such as inheritances, lottery winnings, insurance settlements. Minnesota Valley takes one quarter of the difference of household assets less a $75,000 allowance. These are known as qualified assets. To the extent that qualified assets exceed the patient's portion of the medical bills, the federal poverty guideline allowance will be reduced. Part I, line 6a Minnesota Valley Health Center's community benefit information is consolidated into the Essentia Health community benefit information which is included in the Essentia Health annual report. The annual report is made available to the public via the website at www.essentiahealth.org. Essentia Health, headquartered in Duluth, Minn., is an integrated health system serving patients in Minnesota, Wisconsin, North Dakota and Idaho and is Minnesota Valley Health Center's parent corporation. Part 1, line 7g There are no subsidized costs attributable to a physician clinic. Part I, line 7, column (f) Bad debt expense that was subtracted from total expense to obtain the % of community benefit to total expense amounted to $248,000. Part I, line 7 The cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate the costs for the following community benefits: Charity Care and Unreimbursed Medicaid. Actual costs were used for the remainder of the community benefits reported. Part II - Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves: Not applicable. Part III, line 4 Discounts, charity care, and bad debt expense are accounted for as reductions to revenue. Bad debt expense on patient accounts would be identified as any balance on the account, less any previous payments and discounts, that has aged and is absent of any payments. If, during the collection process, it becomes known that the patient qualifies for charity care, the amounts included within bad debt expense would be reclassified to charity care. Part III, Line 4 MINNESOTA VALLEY HEALTH CENTER is in the process of hiring a 3rd party to track bad debt accounts in order to presumptively quantify accounts within bad debt expense that would have qualified for financial assistance under MINNESOTA VALLEY HEALTH CENTER's financial assistance policy had the proper documentation been completed and filed. As that tracking was not in place during the fiscal year, MINNESOTA VALLEY HEALTH CENTER applied a high-level, conservative analytic review by taking the ratio of charitable allowances to gross patient revenue and multiplying with bad debt expense to arrive at an approximation of charity care that resides in bad debt. Part III, Line 4 Minnesota Valley Health Center is a part of a larger organization, Essentia Health. Essentia Health and its member organizations incorporate the cost of bad debt as a community benefit. As a tax exempt hospital, we must provide the necessary services regardless of the patient's ability to pay for that care. In doing so, Essentia Health makes quality patient care available to all in our community, regardless of their economic means. Part III, line 4 (Excerpt from the parent company's audit) Accounts receivable are stated at net realizable value. The allowance for uncollectible accounts is based upon management's ongoing assessment of historical and expected net collections for each major payor source considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. For receivables associated with private-pay patients, Essentia records a significant provision for uncollectible accounts in the period of service on the basis of its historical experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. Part III, line 8 The costing methodology used in determining the Medicare Allowable Cost reported in the organization's Medicare Cost Report is to take total Medicare costs from the general ledger system and then follow the instructions provided by Centers for Medicare Services (CMS) to back off all costs not allowable. From the Medicare allowable costs, any costs attributable to subsidized health services and costs attributable to GME were subtracted, if applicable. Part III, line 8 Minnesota Valley Health Center is a part of a larger organization, Essentia Health. Essentia Health and its member organizations incorporate the full value of the Medicare shortfall as a community benefit. The rationale for the organization's opinion is providing care for the elderly and serving Medicare patients is an essential part of the community benefit standard. Medicare, like Medicaid, does not pay the full cost of care and it is likely to get worse. Many Medicare beneficiaries are poor and are eligible for Medicaid in addition to Medicare. Medicare underpayment must be shouldered by the hospital in order to continue treating the community's elderly and poor. These underpayments represent a real cost of serving the community. Part III, line 8 Not applicable. Part III, line 9b At any stage of the patient experience, including collections, a determination may be made that the patient qualifies for Financial Assistance. All collection efforts must be suspended while a patient's Financial Assistance application is being considered and until the patient is notified regarding the determination of eligibility. Once eligibility (or lack of eligibility) is determined, amounts still owed by patients will be collected in the same manner as all other patient bills.
Part V, LINE 11HNOT APPLICABLE. PART V, LINE 13G NOT APPLICABLE. PART V, LINE 15E NOT APPLICABLE. PART V, LINE 16E NOT APPLICABLE. PART V, LINE 17E NOT APPLICABLE. PART V, LINE 18C NOT APPLICABLE. PART V, LINE 18D NOT APPLICABLE. PART V, LINE 19D For patients known to qualify for the financial assistance program, discounts will be applied to billed amounts if the patient qualifies for discounted care and the billed amount will be fully discounted if the patient qualifies for free care. PART V, LINE 20 NOT APPLICABLE. PART V, LINE 21 NOT APPLICABLE.
Part VI, line 2Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B: Minnesota Valley Health Center Inc. is a 24 bed critical access hospital located in Le Sueur MN. Minnesota Valley Health Center works with one local primary care physician clinic in Le Sueur, Sibley County Public Health, Nicollet County Public Health and Le Sueur County Public Health agencies for assessing the needs of the rural communities in our area. These needs are determined on several different methods, but mostly based on what these agencies are actually seeing when they are working with their clients. This communication is ongoing throughout the year.
Part VI, line 3Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization's Financial Assistance policy: Minnesota Valley Health Center communicates the availability of financial assistance in appropriate acute care settings such as Emergency Departments, registration areas, and the Business Office. Business office personnel are available at Minnesota Valley Health Center to help patients understand and apply for local, state and federal health care programs and the Minnesota Valley Health Center Financial Assistance Program. All Minnesota Valley Health Center employees are informed annually how to refer patients to apply for the Minnesota Valley Health Center financial assistance program. Annual staff education programs are provided to all Business office staff. Patients can request Financial Assistance information by calling the Financial Assistance patient information phone line on a 24-hour basis. Voicemail is available and all calls will be followed up within three working days. Uninsured patients are provided information regarding the availability of Financial Assistance on registration or admission to Minnesota Valley Health Center. Applications for assistance are available in acute care in-patient registration areas or via mail from the Business office. Contact phone numbers for assistance are also provided. Individuals other than the patient such as the patient's physician, family members, community or religious groups, social services, or hospital personnel may make requests for financial assistance on the patient's behalf.
Part VI, line 4Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves: Minnesota Valley Health Center is located in Le Sueur, MN. Minnesota Valley is a part of the larger Essentia Health system, which is defined in Part VI, line 6. Minnesota Valley Health Center operates a 24 bed critical access hospital, 70 bed long-term care facility, and 37 units HUD-subsidized low income housing for seniors that serve the communities of Le Sueur, Nicollet and Sibley counties. The overall community is classified as rural. Minnesota Valley and its related facilities cover a service region of approximately 28,000 people. The service region age distribution is 21.6% under the age of 18; 64.1% between the ages of 18 and 65; and 14.3% over the age of 65. The racial makeup of the service region is 92.7% Caucasian; 1.5% Black or African American; 0.4% American Indian or Alaskan Native; 1.3% Asian; 1.1% two or more races; and 3.0% other. The gender split ratio is 49.9% women and 50.1% men. The average income for the service area is approximately $62,000. Approximately 6.2% of the population falls below the federal poverty guidelines. Minnesota Valley Health Center, along with Essentia Health is committed to serve patients regardless of their ability to pay. 10.7% net revenue dollars were from self pay patients. In addition, approximately 20.6% of their net revenue dollars were Medicaid recipients. As mentioned above, Minnesota Valley Health Center is part of a larger system, Essentia Health. Essentia Health staffs hospitals and clinics in federally-recognized underserved areas and supports the health of its communities through an active outreach program that brings specialists like oncologists, cardiologists, neurologists and others into its smaller communities. This eliminates barriers to care for many patients, particularly those who are elderly, living on low incomes, or are faced with other challenges that make it difficult to travel long distances for care. There are no other hospitals outside of the Essentia Health umbrella that service the community.
Part VI, line 5Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting the health of the community: Our board of directors is a volunteer board which consists of local community members with a cross section of occupations. Our medical staff consists of our emergency room director and the providers from the Mayo Clinic Health System - Mankato, who has a clinic that is attached to our hospital. Minnesota Valley is an open Medical Staff, so any qualified physician of the community is allowed to apply. All applicants that apply must meet the credentialing standards and be approved by our governing board in order to come and provide services in our system. Due to the low per diem rate which is set by the State for our nursing home, any surplus that is generated is being generated by the hospital services, which in turn keeps the nursing home open. The nursing home loses an average of $300,000 a year providing care to the residents. During the year the nursing home set aside two beds and has de-licensed 10 more beds due to low occupancy and low reimbursement rates. The independent living apartments are also being assisted by the hospital to meet its cash flow needs to provide service to the tenants. Once the needs of the nursing home and the independent living apartments are met, any surplus cash is used to update medical equipment for both the hospital and nursing home. Any and all emergency repairs or equipment needs that arise are taken care of immediately. We keep our daily rates affordable for our Adult Day Health Services and this too is assisted by the hospital services. We provide Adult Day Health Services for our community. This service is on the health center's campus which also consists of a 68 bed nursing home and 24 bed critical-access hospital. Mayo Clinic Health System - Mankato moved out of the wing they were renting from the hospital and have built their own clinic which is attached to the hospital. The hospital is remodeling the vacated wing into an Outpatient services for visiting specialists. We have volunteer members who deliver meals on wheels Monday through Fridays to community members who are in need of this service. At businesses request we go on site for occupational training as requested by the employer. Flu shot clinics are held on site for the community. We have evening events for the community such as Linked in Pink for breast cancer awareness. We participate in local community events such as : Super Saturday Kids Event, Youth Safety Camp, School Supplies drive, Food shelf drive, 5k walk/run events three times a year, We have the emergency helicopter here for events for the community to come and meet them and be aware of these services. During the past year a mini health fair for the community was done free of charge at the annual Retail and Business Expo that was held at the local community center. This was a joint event with the Mayo Clinic Health System - Mankato clinic that is in Le Sueur. We also have an updated website www.mvhc.org on which we are able to get info out to the community. This web site continually has new information being added to it.
Part VI, Line 6If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served: Minnesota Valley Health Center is part of Essentia Health, an integrated health system of 16 hospitals, 65 clinics and several long-term care facilities in four states: Minnesota, Wisconsin, North Dakota and Idaho. The health system serves a predominantly rural population whose median incomes generally fall below averages of the states where they live. The presence of our clinics and hospitals ensures that people with few economic resources don't have to drive an hour or more to receive basic (and in some cases live-saving) medical care. In addition to staffing hospitals and clinics in federally-recognized underserved areas, we support the health of our communities through an active outreach program that brings specialists like oncologists, cardiologists, neurologists and others into our smaller communities. This eliminates barriers to care for many patients, particularly those who are elderly, living on low incomes, or are faced with other challenges that make it difficult to travel long distances for care. Our size and integrated structure allow us to offer patients services often found only in larger urban settings. Services ranging from chemotherapy to congestive heart failure management and hospice are available to patients in many of the rural communities we serve. Essentia Health also supports the health of our rural communities through active research and clinical trials, through the Essentia Institute of Rural Health. The Institute conducts clinical, translational and health services research with a primary focus on the needs of rural Americans. Essentia Health is also serving patients through the use of the Epic electronic health record (EHR). The vast majority of Essentia's hospitals and clinics were using a fully-integrated EHR for patient care. Technology like the electronic health record and telehealth allows health clinicians to share test results and consult with colleagues in real time across great distances. Medical information is no longer lost in the shuffle of paper records - an important consideration in a region where patients must often be transferred to a larger Essentia facility for complex surgeries or medical care. Essentia is also actively working with government agencies and insurers to develop innovative, cost-effective approaches to care that will improve health outcomes while reducing overall costs to patients and insurers. This innovation can be found in our use of remote home monitors for patients with congestive heart failure to a focus on using a team-based approach to helping patients manage chronic diseases. Essentia Health is committed to helping patients and their families lead active and fulfilling lives in the small and large communities where they live. We hope to become a model of health care delivery, particularly in rural areas, in the years to come.
PART VI, LINE 7Minnesota Valley Health Center files a community benefit report in Minnesota.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantNursing Home Scholarship ProgramTypeOfGrant
Number Of Recipients3NumberOfRecipients
Amount Of Cash Grant7080AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchedue I, Part IIIIdentifier
ExplanationProcedures for monitoring grants: Minnesota Valley Health Center Inc provides scholarships for employees who are interested in pursuing an educational program which will lead to career advancement within the facility or within the field of long term care. To be eligible, employees must meet the following criteria: 1. Employee must work an average of 20 hours per week. 2. Employees must be enrolled in a qualified institution working towards an allowable program. 3. Scholarship monies may be used for required tuition, books, fees and any other required expenses. 4. Administrators, department supervisors and registered nurses are not eligible for the scholarship. 5. An employee must submit an application for the scholarship program to the Human Resources Department. The application will be reviewed by the human resources director, long term care administrator and chief financial officer and a decision will be made if the employee is to be awarded the scholarship. No payments will be issued for scholar awards until all appropriate documentation is received from the applicant and the qualified institution.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MICHAEL HEDRIX
02577820603550357150445450437770442174032949
PATRICIA TOWNSDIN
01050960193800693020284010518015597100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSchedule J, Part I, Line 4bIdentifier
ExplanationSupplemental nonqualified retirement plan: Amounts related to participating in a supplemental nonqualified retirement plan are reported in Schedule J, Part II, Column C, and amounts related to receiving payment from a supplemental nonqualified retirement plan are reported in Schedule J, Part II, Column B (iii). The following individuals listed in Form 990, Part VII, Section A, Line 1a received payment from a supplemental nonqualified retirement plan during the year: Michael Hedrix (Critical Access Group) $32,949 PATRICIA TOWNSDIN (Critical Access Group) $0 Critical Access Group's nonqualified retirement plan is offered to Critical Access Group executives. There is a minimum two year vesting date, benefits are subject to income taxes upon vesting, and benefits are payable from Critical Access Group's general assets.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part III, Line 4Program service accomplishments: Minnesota Valley Health Center, Inc. is created & organized exclusively for charitable and educational purposes. Minnesota Valley Health Center, Inc. is created and organized to own, maintain, operate and conduct, directly or indirectly, and to assist and coordinate activities of facilities for health care, education, care for the aged and social services. Minnesota Valley Health Center, Inc. includes a hospital, outpatient specialty clinics, complete lab and radiology departments, a comprehensive physical, occupational and speech therapy department, extended care nursing facilities, an Adult Day Health Center, and independent living senior housing. Minnesota Valley Health Center, Inc. is the 3rd largest employer in a community of approximately 4,000. Minnesota Valley Health Center, Inc. is licensed for 24 beds, had 182 inpatient days, 546 swing bed days, and 23,811 long term care days during the fiscal year ended June 30, 2012. There were 1,783 emergency room visits and 17,716 outpatient visits during the same time period. Also, during fiscal year 2012 there were 1,434 meals delivered to community members through the Meals on Wheels Program and 4,726 meals were served to residents at the independent living apartments. The adult day health service saw an average of 6 clients a week. Minnesota Valley Health Center, Inc provided over $21,000 in charity care during the fiscal year ended June 30, 2012. Further community benefits provided during the fiscal year include community services of over $6,000 and subsidized health services of over $21,000.
Form 990,Part VI, Line 6Members of Organization: City of Le Sueur and Critical Access Group may elect one or more members of the governing body as described in Schedule O Part VI Line 7a. Essentia Health has reserved powers with respect to Minnesota Valley Health Center, Inc. as described in Schedule O Part VI Line 7b.
Form 990, Part VI, Line 7aMember with right to elect governing body: According to its Bylaws, the City of Le Sueur shall appoint and remove one board member. Critical Access Group shall appoint and remove Minnesota Valley Health Center, Inc.'s remaining governing body.
Form 990, Part VI, Line 7bMembers with right to approve governing body decision: Minnesota Valley Health Center, Inc. is a subsidiary of Essentia Health, whose Board of Directors has reserved powers with respect to this corporation and its subsidiaries, and all of the other direct and indirect subsidiaries of Essentia Health (collectively, the "System"). Essentia Health's reserved powers are as follows: Strategic and Business Plans. Authority to create, and to approve, the System's strategic and business plans. Mission. Authority to create, and to approve, the mission, purpose and vision statements for all entities in the System by the affirmative vote of at least 67% of the Essentia Health board of directors. Debt. Approval of the incurrence of debt by, and the creation of all mortgages, liens, security interests, or other encumbrances on the assets of, all entities in the System in excess of the single or annual aggregate dollar limits prescribed in writing by the Essentia Health board of directors, and the authority to cause all entities in the System to participate in System borrowing. Governing Instruments. Authority to cause, and to approve, amendments of the articles of incorporation and bylaws of all entities in the System. Mergers and Acquisitions. Authority to cause, and to approve, all mergers, consolidations, and dissolutions of all entities in the System. Affiliations and Joint Ventures. Authority to cause, and to approve, all affiliations, joint ventures and other alliances with third parties of all entities in the System. Transfer of Assets Within the System. Authority to transfer assets, including cash, between and among entities within the System; provided, however, that Essentia Health shall not have authority to require any entity in the System to transfer assets (a) that would cause such entity to be in default of its covenants or obligations under any bond or other financing documents; (b) from the Catholic entities to the secular entities or from the secular entities to the Catholic entities in a manner or to an extent that would cause the Catholic entities to be in violation of the Ethical and Religious Directives for Catholic Health Care Services in the judgment of the local ordinary; or (c) such that money generated by services at secular facilities within the System by procedures that are contrary to the Ethical and Religious Directives for Catholic Health Care Services would be used at the Catholic entities or money generated by Catholic entities would be used in the providing of services contrary to the Ethical and Religious Directives for Catholic Health Care Services at secular facilities within the System. Transfer of Assets Outside the System. Authority to cause, and to approve, the sale, lease or other transfer of assets of all entities in the System to parties outside of the System when the asset's value exceeds the single or annual aggregate dollar limits prescribed in writing by the Essentia Health board of directors. Services. Authority to cause, and to approve, the addition of new services and service locations and the discontinuance of services and service locations within all entities in the System. Budgets. Approval of capital and operating budgets of all entities in the System. Professional Services. Selection of the general legal counsel and external auditors of all entities in the System. Acquisitions. Authority to cause, and to approve, all acquisitions by and formations of entities in the System. Marketing. Authority to implement System-wide marketing and promotional activities. Compliance Plans. Authority to create, and to approve, corporate compliance, safety and risk management plans for entities within the System. Quality Plan. Authority to create, and to approve, the System's quality plan. Non-Budgeted Purchases. Approval of non-budgeted capital purchases and leases in excess of the single or annual aggregate dollar limits prescribed in writing by Essentia Health for entities within the System. Human Resources. Authority to create human resource policies and procedures within the System. Reserved Powers. Authority to create additional Essentia Health reserved powers by the affirmative vote of at least 80% of the Essentia Health board of directors (excluding the Essentia Health CEO); provided, however, that any additional Essentia Health reserved powers shall not contravene or hinder the reserved powers of Benedictine Sisters Benevolent Association. Form 990, Part VI, Section A, Line 8b Committees: There are no committees with authority to act on behalf of the governing body.
FORM 990, PART VI, LINE 11AFORM 990 REVIEW PROCESS: The 2011 Form 990 including all schedules was reviewed by Minnesota Valley Health Center, Inc. management and governing body on April 23, 2013 prior to filing with the Internal Revenue Service. Each current director of the governing body received a copy of the 2011 Final Form 990. Minnesota Valley Health Center, Inc.'s Chief Financial Officer led the review of the form and schedules and any questions were discussed.
FORM 990, PART VI, LINE 12CMonitoring and enforcing Conflict of Interest policy: Interested persons annually disclose relationships which might lead to a conflict of interest by completing a conflict of interest disclosure form. Interested persons include any person in a position to exercise substantial influence over the organization. It includes but is not limited to any director, officer, management, employee, or committee member of Essentia Health or any of its affiliates. Essentia is responsible for the annual distribution of conflict of interest forms and review of disclosures for the governing bodies of Essentia and Essentia Operating Members and for senior management employees of Essentia. Transactions with parties with whom a conflict of interest exists may be undertaken only if all of the following are observed: the conflict of interest is fully disclosed; the interested person with the conflict of interest doesn't participate in the approval of such transactions; if practical or appropriate, a competitive bid or comparable valuation is obtained; and the board or committee of the board has determined that the transaction is in the best interest of the organization. Disclosure by any interested person other than a board or committee member should be made to the Chief Executive Officer (or if she/he is the one with the conflict, then to the board chair), who will bring the matter to the attention of the board or an appropriate committee of the board. Disclosure involving board or committee members should be made to the board chair (or if she/he is the one with the conflict, then to the board vice chair), who will bring these matters to the board or an appropriate committee of the board. The board or committee of the board will determine whether a conflict exists and if so, whether the contemplated transaction may be authorized as just, fair, and reasonable to Essentia or its affiliate(s). The decision of the board or a duly constituted committee of the board on these matters will be at its sole discretion, and its concern must be the welfare of Essentia and its affiliate(s) and the advancement of its purposes. The decision of the board is final. If the board determines a conflict does not exist, the interested person may proceed with the transaction; however, he/she will not be eligible to vote on related issues should they arise. If the board determines a conflict does exist, the interested person will be notified of the decision regarding whether the contemplated transaction will be authorized as just, fair, and reasonable.
Form 990, Part VI, Section B, Line 15aThe organization has a compensation committee that uses compensation studies to determine the compensation of all employees including the President. Any salary adjustment for the President is reviewed and approved by the board of directors. The year this process was last undertaken for Minnesota Valley Health Center's President was during 2009. FORM 990, PART VI, LINE 19 Availability of governing documents, conflict of interest policy, & financial statements to the public: Minnesota Valley Health Center, Inc. makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Minnesota Valley Health Center, Inc. is part of Essentia Health's consolidated financial statements which are included in Essentia Health's annual report posted on Essentia Health's web site.
Part VII Section A Line 1a Column BHours devoted to related organizations: The following individual listed in Form 990, Part VII, Section A, Line 1a also devoted time each week to related organizations: Michael Hedrix is employed by Critical Access Group as Critical Access Group Senior Vice President of Operations. 100% of his time is spent furthering the purpose of Critical Access Group and related organizations.
Form 990, Part XI, Line 5Other Changes in Net Assets: The total amounts of other changes in net assets include: Unrealized loss on trading securities: ($5,884) Change in Beneficial Interest of Minnesota Foundation: $196,089
FORM 990, Part XII, Line 3Consolidated A-133: MINNESOTA VALLEY HEALTH CENTER, INC., as part of Essentia Health's consolidated financial statements, was required and underwent a consolidated audit set forth in the Single Audit Act and OMB Circular A-133. The consolidated audit is reviewed by the Essentia Health Audit Committee.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (28 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
BRAINERD LAKES INTEGRATED HEALTH SYSTEM
2024 S 6TH STBRAINERDMN56401371532145SUPPORT ORGMN501(c)(3)11 IIESSENTIAtrue
BRAINERD MEDICAL CENTER INC
2024 S 6TH STBRAINERDMN56401371532148CLINICMN501(c)(3)3BLIHStrue
ST JOSEPH'S MEDICAL CENTER
523 N 3RD STBRAINERDMN56401410695602CLINIC/HOSPMN501(c)(3)3BLIHStrue
CLEARWATER VALLEY HOSPITAL & CLINICS INC
301 CEDAROROFINOID83544820497771CLINIC/HOSPID501(c)(3)3CAGtrue
DL SURGERY CENTER
1027 WASHINGTON AVEDETROIT LAKESMN56501263837203ASCMN501(c)(3)3CAGtrue
STBENEDICTS FAMILY MED CTR thru 10111
709 N LINCOLNJEROMEID83338820227163CLINIC/HOSPID501(c)(3)3CAGtrue
ST MARY'S HOSPITAL & CLINICS INC
PO BOX 137COTTONWOODID83522820226453CLINIC/HOSPID501(c)(3)3CAGtrue
CRITICAL ACCESS GROUP
503 E 3RD ST STE 400DULUTHMN55805261219624SUPPORT ORGMN501(c)(3)11 IIESSENTIAtrue
ESSENTIA INSTITUTE OF RURAL HEALTH
502 E 2ND STDULUTHMN55805271291124RESEARCHMN501(c)(3)4ESSENTIAtrue
INNOVIS HEALTH LLC
3000 32ND AVEFARGOND58103261175213CLINIC/HOSPDE501(c)(3)3ESSENTIAtrue
ST MARY'S DULUTH CLINIC HEALTH SYSTEM
407 E 3RD STDULUTHMN55805411836633SUPPORT ORGMN501(c)(3)11 IIESSENTIAtrue
BRIDGES MEDICAL CENTER
201 9TH ST WADAMN56510200479568CLINIC/HOSPMN501(c)(3)3INNOVIStrue
ESSENTIA HEALTH FOUNDATION
502 E 2ND STDULUTHMN55805271984704FOUNDATIONMN501(c)(3)7ESSENTIAtrue
FIRST CARE MEDICAL SERVICES
900 HILLIGROSS BLVD SEFOSSTONMN56542410706143CLINIC/HOSPMN501(c)(3)3INNOVIStrue
GRACEVILLE HEALTH CENTER
115 WEST SECOND STGRACEVILLEMN56240410726173CLINIC/HOSPMN501(c)(3)3INNOVIStrue
ST MARY'S INNOVIS HEALTH
1027 WASHINGTON AVEDETROIT LAKESMN56501262861321CLINICMN501(c)(3)3INNOVIStrue
ST MARY'S REGIONAL HEALTH CENTER
1027 WASHINGTON AVEDETROIT LAKESMN56501411620386CLINIC/HOSPMN501(c)(3)3INNOVIStrue
ESSENTIA HEALTH
502 E 2ND STDULUTHMN55805200360007SUPPORT ORGMN501(c)(3)11 III-FINAfalse
DIVINE MEDICAL SERVICES thru 10111
709 N LINCOLNJEROMEID83338202773717EMERG SRVSID501(c)(3)3SBFMCtrue
MIDWEST MEDICAL EQUIPMENT & SUPPLY INC
4418 HAINES RDDULUTHMN55811411674021MEDICAL EQUIPMN501(c)(3)9SMMCtrue
NORTHERN PINES MEDICAL CENTER
5211 HWY 110AURORAMN55705410841441HOSPITAL/NURSMN501(c)(3)3SMDCHStrue
PINE MEDICAL CENTER
109 COURT AVE SSANDSTONEMN55072411884597HOSPITAL/NURSMN501(c)(3)3SMDCHStrue
SMDC MEDICAL CENTER
502 E 2ND STDULUTHMN55805411878730CLINIC/HOSPMN501(c)(3)3SMDCHStrue
ST MARY'S MEDICAL CENTER
407 E 3RD STDULUTHMN55805410695604HOSPITALMN501(c)(3)3SMDCHStrue
THE DULUTH CLINIC LTD
400 E 3RD STDULUTHMN55805410883623CLINICMN501(c)(3)3SMDCHStrue
POLINSKY MEDICAL REHABILITATION CENTER
530 E 2ND STDULUTHMN55805410691275CLINICMN501(c)(3)3SMMCtrue
ST MARY'S HOSPITAL OF SUPERIOR
3500 TOWER AVESUPERIORWI54880411811073CLINIC/HOSPWI501(c)(3)3SMMCtrue
ST MARY'S EMS
1027 WASHINGTON AVEDETROIT LAKESMN56501411805811EMERG SRVSMN501(c)(3)9SMRHCtrue

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PMC-Gateway Imaging LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1109 Court Ave SAddressLine1
CitySandstoneCity
StateMNState
ZIP Code55072ZIPCode
FieldValueIRS element (for citing)
EIN261634764EIN
Primary ActivityImaging ServiCESPrimaryActivity
Legal Domicile StateMNLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeNONEPredominantIncomeType
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Code V$0CodeVAmount
Percentage Ownership0.00000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
East Range Clinics Ltd
910 6th Ave NVirginiaMN55792410909915ClinicsMNNAC Corp000.00000
Essentia Health Insurance Services SPC
000000000InsuranceNAForeign Corp000.00000Buckingham Sq 720 W Bay Rd PO 69Grand CaymanCayman IslandsCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Critical Access Group
l245580actual costs
Critical Access Group
o979078actual costs
Essentia Health
o200613actual costs

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierSchedule R, Part II, Column (a)Identifier
ExplanationName: In 2011, many Essentia entities adopted a doing business as name as part of a system-wide rebranding strategy using the Essentia brand. Legal Name; Doing Business As Name Brainerd Lakes Integrated Health System; Essentia Health Central Brainerd Medical Center, Inc.; Essentia Health Brainerd Specialty Clinic Bridges Medical Center; Essentia Health Ada First Care Medical Services; Essentia Health Fosston Graceville Health Center; Essentia Health Holy Trinity Hospital Innovis Health, LLC; Essentia Health West Midwest Medical Equipment & Supply Inc.; Essentia Health Medical Equipment and Supplies Northern Pines Medical Center; Essentia Health Northern Pines Pine Medical Center; Essentia Health Sandstone Polinsky Medical Rehabilitation Center; Essentia Health Polinsky Medical Rehabilitation Center SMDC Medical Center; Essentia Health Duluth St. Joseph's Medical Center; Essentia Health St. Joseph's Medical Center St. Mary's Duluth Clinic Health System; Essentia Health East St. Mary's Hospital of Superior; Essentia Health St. Mary's Hospital-Superior St. Mary's Medical Center; Essentia Health St. Mary's Medical Center St. Mary's Regional Health Center; Essentia Health St. Mary's-Detroit LakesExplanation