RANGE REGIONAL HEALTH SERVICES: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- RANGE REGIONAL HEALTH SERVICES (EIN 41-1293970)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201333199349302508
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T09:17:48-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411293970 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANGE REGIONAL HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | RANG | NameControl |
| Phone | 2183626657 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 EAST 34TH STREET | AddressLine1 |
| City | HIBBING | City |
| State | MN | State |
| ZIP Code | 55746 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEBRA BOARDMAN | Name |
| Title | PRESIDENT | Title |
| Phone | 2183626657 | Phone |
| Date Signed | 2013-11-15 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DEBRA BOARDMAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 East 34th Street | AddressLine1 |
| City | Hibbing | City |
| State | MN | State |
| ZIP Code | 55746 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 99455899 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.range.fairview.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1998 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | To provide a regional integrated network of health care services through physicians, ambulatory care, and hospital facilites. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1032 | TotalNbrEmployees |
| Total Nbr Volunteers | 210 | TotalNbrVolunteers |
| Total Gross UBI | 3383325 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1270659 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 821177 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 455502 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 90893889 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 97975632 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 323029 | InvestmentIncomePriorYear |
| Investment Income Current Year | 920527 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 111323 | OtherRevenuePriorYear |
| Other Revenue Current Year | 104238 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 92149418 | TotalRevenuePriorYear |
| Total Revenue Current Year | 99455899 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 59613681 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 63256437 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 36277354 | OtherExpensePriorYear |
| Other Expenses Current Year | 35955435 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 95891035 | TotalExpensesPriorYear |
| Total Expenses Current Year | 99211872 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3741617 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 244027 | RevenuesLessExpensesCY |
| Total Assets BOY | 72445113 | TotalAssetsBOY |
| Total Assets EOY | 70827144 | TotalAssetsEOY |
| Total Liabilities BOY | 49776398 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 48036326 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 22668715 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 22790818 | NetAssetsOrFundBalancesEOY |
| Mission Description | Range Regional Health Care is an integrated health care system meeting the needs of our patients in an exemplary manner. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 84826151 | Expense |
| Revenue | 97975632 | Revenue |
| Description | Range maintains and operates a hospital to provide medical and surgical care to the sick, infirm, aged, or injured. | Description |
| Total Program Service Expense | 84826151 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 137 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1032 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tom Fink | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2183626638 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 E 34TH STREET | AddressLine1 |
| City | HIBBING | City |
| State | MN | State |
| ZIP Code | 55746 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Charlie Crep | |||||||
| Chairman | 5.00 | X | 0 | 0 | 0 | ||
| Kathy Sterk | |||||||
| Vice Chairman | 4.00 | X | 0 | 0 | 0 | ||
| Mike Raich | |||||||
| Treasurer | 4.00 | X | 0 | 0 | 0 | ||
| Dr Susan Rudberg | |||||||
| Secretary | 4.00 | X | 0 | 0 | 0 | ||
| Brad Anderson | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Dan Aageness | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Scott Maki | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Shelly Valentini | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Rachel Sullivan | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Dan Anderson | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| John Doherty | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Debra Rudquist | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Beth Gohdes | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Mike Fay | |||||||
| Director | 4.00 | X | 0 | 0 | 0 | ||
| Debra Boardman | |||||||
| President & CEO | 40.00 | 0 | 267743 | 24744 | X | ||
| John Kritz | |||||||
| CFO | 40.00 | 188190 | 0 | 0 | X | ||
| Jim Bymark | |||||||
| Senior Officer | 40.00 | 147231 | 0 | 0 | X | ||
| David Hohl | |||||||
| Senior Officer | 40.00 | 146022 | 0 | 0 | X | ||
| Vicky Korynta | |||||||
| COO | 40.00 | 194446 | 0 | 0 | X | ||
| Shelly A Maki | |||||||
| CNO | 40.00 | 127200 | 0 | 0 | X | ||
| Thomas Fink | |||||||
| Director of Finance | 40.00 | 121219 | 0 | 0 | X | ||
| James E Hartert | |||||||
| VP Medical Director | 40.00 | 243655 | 0 | 0 | X | ||
| Dr Kristin Fredrickson | |||||||
| Physician | 40.00 | 525852 | 0 | 0 | X | ||
| Elizabeth Jones | |||||||
| Physician | 40.00 | 405735 | 0 | 0 | X | ||
| Sandra Hanson | |||||||
| Physician | 40.00 | 401183 | 0 | 0 | X | ||
| Lane meyer | |||||||
| Physician | 40.00 | 435955 | 0 | 0 | X | ||
| Scott Stenstrom | |||||||
| Hospitalist | 40.00 | 413034 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3349722 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 267743 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 24744 | TotalOtherCompensation |
| Number Individuals GT100 K | 63 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Emergency Practice Associates Inc | |||||
| 3840 W 9th Street | Waterloo | IA | 50702 | Professional Fees | 1827975 |
| Central Minnesota Diagnostic Inc | |||||
| 150 10th Street NW PO Box 158 | Milaca | MN | 56353 | Purchased Services | 1668655 |
| Fairview Health Services | |||||
| 400 Stinson Blvd NE | Minneapolis | MN | 55413 | Professional Fees | 879752 |
| University of MN Physicians | |||||
| 720 Washington Ave SE Ste 200 | Minneapolis | MN | 55414 | Professional Fees | 568238 |
| Quest Diagnostics Inc | |||||
| 1355 Mittel blvd | Wood Dale | IL | 60191 | Purchased Services | 395722 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 21 | NumberOfContractorsGT100K |
| Related Organizations | 417975 | RelatedOrganizations |
| All Other Contributions | 37527 | AllOtherContributions |
| Total Contributions | 455502 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE RE | 621500 | 94154269 | 94154269 | |
| HEALTHLINE | 900099 | 3383325 | 3383325 | |
| CAFERERIA REVENUE | 722210 | 410680 | 410680 | |
| PHARMACY REVENUE | 446110 | 27358 | 27358 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 97975632 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 910523 | TotalRevenueColumn |
| Exclusion | $910,523 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 104238 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 104238 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 104238 | TotalRevenueColumn |
| Exclusion | $104,238 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 10004 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 10004 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10004 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10004 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 99455899 | TotalRevenueColumn |
| Related Or Exempt Function Income | 94602311 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3383325 | UnrelatedBusinessRevenue |
| Exclusion | $1,014,761 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2235705 | Total |
| Program Services | 1117853 | ProgramServices |
| Management And General | 1117852 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46353832 | Total |
| Program Services | 40426201 | ProgramServices |
| Management And General | 5927631 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3692634 | Total |
| Program Services | 3157202 | ProgramServices |
| Management And General | 535432 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7541156 | Total |
| Program Services | 6447688 | ProgramServices |
| Management And General | 1093468 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3433110 | Total |
| Program Services | 2935309 | ProgramServices |
| Management And General | 497801 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12595812 | Total |
| Program Services | 10769419 | ProgramServices |
| Management And General | 1826393 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35611 | Total |
| Program Services | 30447 | ProgramServices |
| Management And General | 5164 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3361958 | Total |
| Program Services | 2874474 | ProgramServices |
| Management And General | 487484 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 765958 | Total |
| Program Services | 654894 | ProgramServices |
| Management And General | 111064 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5024477 | Total |
| Program Services | 4295929 | ProgramServices |
| Management And General | 728548 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 633402 | Total |
| Program Services | 541559 | ProgramServices |
| Management And General | 91843 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 10444608 | 8930140 | 1514468 |
| TAXES | 1965939 | 1680878 | 285061 |
| OTHER | 980491 | 838320 | 142171 |
| TELEPHONE | 147179 | 125838 | 21341 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99211872 | Total |
| Program Services | 84826151 | ProgramServices |
| Management And General | 14385721 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1155957 | BOY |
| EOY | 3170736 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2719537 | BOY |
| EOY | 2776808 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11933488 | BOY |
| EOY | 12527496 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2027895 | BOY |
| EOY | 1880685 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1440861 | BOY |
| EOY | 1798727 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 86547450 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 50265801 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39611629 | BOY |
| EOY | 36281649 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13555746 | BOY |
| EOY | 12391043 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72445113 | BOY |
| EOY | 70827144 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29238507 | BOY |
| EOY | 29505506 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10603 | BOY |
| EOY | 10561 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17255439 | BOY |
| EOY | 16915120 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3271849 | BOY |
| EOY | 1605139 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49776398 | BOY |
| EOY | 48036326 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22360631 | BOY |
| EOY | 22285526 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 308084 | BOY |
| EOY | 505292 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22668715 | BOY |
| EOY | 22790818 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72445113 | BOY |
| EOY | 70827144 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 244027 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 98845 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -220769 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 0 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 374539 | OtherCostOrOtherBasis |
| Book Value | 374539 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 33864896 | OtherCostOrOtherBasis |
| Depreciation | 25009371 | Depreciation |
| Book Value | 8855525 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1553310 | OtherCostOrOtherBasis |
| Depreciation | 1251545 | Depreciation |
| Book Value | 301765 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50716515 | OtherCostOrOtherBasis |
| Depreciation | 24004885 | Depreciation |
| Book Value | 26711630 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 38190 | OtherCostOrOtherBasis |
| Book Value | 38190 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 36281649 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Asset Limited As To Use | 11176820 |
| Diagnostic, Inc | 1084254 |
| Deferred Debt Acquisition | 129969 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 12391043 | TotalBookValueOtherAssets |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 120.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 275.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2333663 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2333663 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02350 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23485142 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13141529 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10343613 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10430 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 25818805 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13141529 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12677276 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12780 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 116444 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 116444 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 498302 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 498302 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 80997 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 80997 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 695743 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 695743 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00700 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26514548 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13141529 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13373019 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13480 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 10019 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10019 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 404 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 404 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 10423 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10423 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,402,439 | BadDebtExpenseAmount |
| Amount Attributable To | 48049 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 42094670 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 56832682 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -14738012 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Range Regional Health Services | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 East 34th St | AddressLine1 |
| City | Hibbing | City |
| State | MN | State |
| ZIP Code | 55746 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Range Regional Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 120.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 275.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Lawsuit | X | Lawsuit |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 1 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 3c: In support of our values and mission and in compliance with the Minnesota Attorney General Agreement signed by Fairview, Fairview is providing uninsured patients with a household income below $125,000 an uninsured discount on billed charges equivalent to Fairview's highest revenue private payer contracted rate for medically necessary services. | ||
| Part I, L7 Col(f): The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. The amount of bad debt expense included on form 990, Part VIII, line 2a, column (B) is used as a reduction to income according to accepted GAAP principles. | ||
| Part II: Range Regional Health Services is a regional health care system based out of Hibbing, Minnesota and is comprised of Fairview University Medical Center - Mesabi, Fairview Mesaga Clinics, and Fairview Healthline. Fairview Range has clinics, medical supply stores, and provides home care/hospice/transportation services throughout the region.Range Regional Health Services is located in Northeastern Minnesota approximately 72 miles Northwest of Duluth and 190 miles due North of Minneapolis/St. Paul, Minnesota on what is called Minnesota's famed "Iron Range".For many of its services, Range Regional Health Services, serves a population base of over 133,000 residents. It covers a geographic range of 45 miles to the West, 100 miles to the North and 70 miles to the East and 30 miles to the South. Fairview Range is a true regional referral center for radiation, oncology and behavioral health services with patients coming from across North East Minnesota.The population Fairview Range serves is made up of approximately 66,080 males and 67,000 females with the mediam family annual income ranging from $33,500 to $37,000. Fairview Range has a diverse population made up of a variety of races and ethnic groups.With more than 60 local physicians and over 1,000 employees, Fairview Range has the largest active medical staff on the Iron Range and is the area's 2nd largest employer. Range Regional Health Services offers highly-advanced inpatient and outpatient medical services, and along with our professional staff, provides the most comprehensive health care services on the Iron Range and North to the Canadian Border.Range Regional Health Services utilizes true state-of-the-art technology, with some of the newest equipment and facilities in the region. With the installation of the most advanced CT Scanner in the area, a newly expanded and enhanced radiation oncology center, a new comprehensive breast center, and a new constructed and expanded emergency and urgent care center, Fairview Range truly provides the latest in high quality healthcare right in, or close by, your home community. | ||
| Part III, Line 4: The provision for bad debts is based on management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. Fairview uses the cost to charge ratio method for determining expenses. | ||
| Part III, Line 8: Range Regional Health Services uses the cost to charge ratio method for determining expenses. The Medicare cost to charge ratio reporting is calculated service line by service line. Other expenses are calculated using the overall cost to charge ratio.Medicare Advantage patients and not cost report services, plus non-allowable costs allocated to Medicare patients also generate a shortfall of $14,738,013 not included in Part III, Sec. B Line 7 or reported elsewhere. | ||
| Part III, Line 9b: After our patients have received services, it is the policy of Range Regional Health Services to bill patients and their applicable payors on a timely and accurate basis. During this billing and collection process, Fairview staff committed to providing quality customer service and timely follow up on all outstanding accounts. Billing: It is the goal of Range Regional Health Services to bill all claims accurately and on a timely basis. Although dependent on information and communications from patients and payors, Range Regional Health Services will provide sufficient follow up service to ensure that patients receive accurate account and billing information and have the opportunity to make payment and/or apply for community care. Fairview Health Services has agreed to certain billing and collection practices by an agreement with the Minnesota Attorney General's office and Range Regional Health Services follows this agreement. There are financial counselors at every entity Monday through Friday who interact with the patients in person and over the phone to tell them about programs that are available as well as help them apply for the programs. The information about needing help paying the bill is on signs in the hospitals and materials are distributed to self pay patients by registration staff. The statements sent out after the visit provide this information too. If a patient/family member calls the Central Business Office customer service staff to say they need assistance paying the bill they are informed about options at that time as well. Range provides a service that you call and this service interprets conversaton over the phone. This service can be used either as a three way phone call or the Financial Counselor, in a room with the patient or family can make the call together to the interpreter phone service. The interpreter services has close to 200 languages.The billing process will be assisted by the following guidelines:1) For all insured patients, Range will bill all third party payor information (as provided by or verified by the patient) on a timely and accurate basis.2) For all uninsured patients with Minnesota residency receiving hospital based services deemed medically necessary. Fairview will apply an uninsured discount equal to the discount provider to our largest contracted non-government payor, any remaining balance will be billed to the patient in a timely and manner.3) All billed patients have the opportunity to contact Range regarding financial assistance for their accounts. Financial assistance may include Community Care, payment arrangements, medical assistance or other applicable programs.4) If a patient contacts Range Regional Health Services regarding Community Care, the account will not be referred to a collection agency or attorney. Once the application and required documentation is received (income verification etc.), the account will then be processed based on the outcome of the Community Care determination.5) If a patient contacts Range Regional Health Services regarding Community Care after their account has been referred to a collection agency or attorney, Fairview will send an application to the patient provided the account meets the Community Care requirements. If the completed application with required documents (income verification, etc.) is submitted, all collection action will be suspended until the patient is notified of Range's determination. | ||
| Part V, Section B, Line 3: Fairview Range, along with Fairview Community Health provided leadership for the 2012 Fairview Range CHNA. Fairview Range reached out to members of our community in the fourth quarter of 2011, asking a diverse group of community leaders to represent the community by becoming a member of the CHNA Steering Committee. The following are members of that Steering Committee:Officer Greg Benedict, School Liaison Police Officer, Hibbing Police DepartmentSheri Biondi, Director of Service Learning, Hibbing Community CollegeCheryl Bisping, Community Health CoordinatorDebra Boardman, President, Fairview Range Regional Health ServicesRoy Connaughton, CEO, Arrowhead Center Inc.Ann Ellison, Fairview Community HealthSue Erzar, RN, Public Health Division Manager, Itasca County Public HealthCarrie Estey-Dix, Clinic Coordinator, Project Care Free Clinic Harry Grinage, Range Respite James Hartert, M.D., Vice President, Medical Director, Fairview Range Regional Health ServicesTammi Hoard, Medical Case Manager, Rural AIDS Action NetworkDavid Hohl, Vice President Business Development, Fairview Range Regional Health ServicesCyndi Klobuchar, RN, Fairview UMCM, Patient Care Supervisor, Medical-SurgicalHeidi Lahti, Manager, Fairview Diagnostic ImagingAnita Provinzino, Director, Housing and Development AuthorityShelley Robinson, Executive Director, Range Center Inc.Sgt. Jeff Ronchetti, Community Liaison Officer, Hibbing Police DepartmentDeb Rudquist, Cardiovascular Service Line Executive, Fairview Health Services & Fairview Range Board MemberJessica Schuster, Fairview Marketing SpecialistSue Soroko, RN, St. Louis County Public Health Shelly Valentini, Executive Director, United Way of NE MN & member of Fairview Range board | Range Regional Health Services | |
| Part V, Section B, Line 5c: www.fairview.org/fv/groups/internet/documents/web_content/s_093141 | Range Regional Health Services | |
| Part V, Section B, Line 7: While not identified as one of the communitys top three health needs, health information and education is something that Fairview Range sees as a priority. The CHNA data related to health information and education will be communicated across the organization. Efforts will be made to increase and improve all aspects of health information and education that are provided broadly to the community. | Range Regional Health Services | |
| Part V, Section B, Line 10: In support of our values and mission and in compliance with the Minnesota Attorney General Agreement signed by Range Regional Health Services, Range Regional Health Services is providing uninsured patients with a household income below $125,000 an uninsured discount on billed charges equivalent to Range Regional Health Services' highest revenue private payer contracted rate for medically necessary services. | Range Regional Health Services | |
| Part V, Section B, Line 11: Patients with incomes up to 275% of the federal poverty level qualify for a 100% discount on total charges. Therefore, no determination has to be made on the maximum amount that can be charged to FAP-eligible individuals for emergency or other medically necessary care. | Range Regional Health Services | |
| Part V, Section B, Line 16e: It is the goal of Range Regional Health Services to bill all claims accurately and on a timely basis. Although dependent on information and communication from patients and payors, Range Regional Health Services will provide sufficient follow up service to ensure that patients receive accurate account and billing information and have the opportunity to make payment and or apply for Community Care. | Range Regional Health Services | |
| Part V, Section B, Line 20d: Fairview Range Community Care Program, Discount program, and other charity care plans do not cover the following: Those procedures that are not medically necessary, cosmetic, pharmacy, hearing aids, chiropractic services, services not covered by Minnesota Medical Assistance and other insurances, services which you may be responsible for if you do not receive county assistance, professional services rendered at our facilities by independent physicians, out-of-network services, hospice, homecare, DME, Greenview alzheimer's, retail store, foreign or out of state services, services that would have qualified for insurance coverage if received at another facility or services not billed or received at Fairview Range. | Range Regional Health Services | |
| Part V, Section B, Line 22: Patients who do not comply with the Community Care application process may be denied Community Care. Patients who have insurance and payment has not been received from the insurance company will be denied Community Care if the applicant fails to cooperate with claims filing or collecting from potential third party resources. Other exclusions include services from non-Range Regional Health Services providers, other Range Regional Health Services providers not covered by the Charity Care policy and expenses related to transportation or personal living expenses. Non-US Citizens are not eligible for Community Care unless they are an undocumented alien and have established residence in the United States. Out-of-state residents are not eligible for 100 percent Community Care Discount. | Range Regional Health Services | |
| Part VI, Line 2: Community needs assessments are conducted by Fairview corporate community health department staff every year on a rolling three year cycle for the primary service areas within Fairview Health Services. Year 1: Basic Demographic Assessments Year 2: Adolescent Assessments Year 3: Site or Issue Specific Assessments (e.g. analysis of charity care patients). Staff begin with existing community documents to build a baseline of information. This information may include patient data, existing recent social and cultural reports, education and business reports, new demographic information about income, housing, education and more. Next, staff conduct key interviews with community leaders from diverse sectors: social services, philanthrophy, government, health, education, business, minority groups, faith groups. Interviews allow assumptions to be validated and new information to be gathered. In addition, site community health staff partner with local public health departments and other community groups as part of their supplemental assessment of community need and/or to utilize the findings from their groups to better understand their communities. Fairview Health Services and Range Regional Health Services participate in the State Health Improvement Program (SHIP) community assessments. Range Regional Health Services financially sponsored the Bridge to Health Survey which is a population-based health status survey conducted in Northeastern Minnesota and Northwestern Wisconsin. Data from this survey is utilized in program planning.Identified needs include adolescent health based on the assessment of diet, nutrition and exercise. | ||
| Part VI, Line 4: Beyond the formal needs assessments, Fairview leadership is engaged in their respective communities. Involvement includes participation on community boards, foundations, schools and more. Fairview also seeks community involvement through, community leaders serving on hospital boards and committees. Information gleaned through these connections are equally as important as the formal needs assessments. These connections can often identify emerging issues. | ||
| Part VI, Line 5: Range Regional Health Services is governed by an unpaid Board of Directors. The majority of the directors are community members who represent the various service areas and entities within the system.As a nonprofit health system Fairview Range reinvests and excess revenues beyond expenses into the core operations of the organization. In 2009, Fairview Range started a three-year project to immplement an integrated electronic medical record across thecontinuum. This is a significant investment in critical quality and efficiency. Fairview Range partners with Myriad higher education institutions to provide clinical hand-on training for future nurses, pharmacists, laboratory professionals and more.Fairview Range is an active community member. Leaders from Range Hospital and Clinics are involved in their community through leadership on community boards,legislative and regulatory boards and much more.When someone is sick or injured, the emergency departments (ED) at Fairview Range serve as front door for all individuals seeking medical care. The EDs are part of a critical safety net of services for uninsured individuals and families. For individuals who are unable to pay for their care, Fairview Range offers charity care on a sliding fee based on income. Fairview Range also provides an automatic discount on all bills for uninsured individuals. The discount is equal to the discount provided to the organization's largest commercial insurer.Range Hospital and Clinics participate in government programs such as medicare, medicaid, general assistance and tricare. Range Regional Health Services provides for a large number of individuals covered by medicaid. The amount of medicaid volume make Range Hospital a disproportionate share recipient. | ||
| Part VI, Line 6: Range Regional Health Services is an affiliate of Fairview Health Services, an integrated health care system headquartered in Minneapolis, Minnesota. Based on the health care needs in that service area, community benefit activity is carried out by staff/leadership at that facility. The Fairview Health Services Corporate Community Health Department supports the local effort by sharing best practices, finding efficiencies amoung hospital community health leaders as appropriate, coordinating the formal community needs assessments and more including medical staff that provide services at Project Care-Free Clinics. These same efforts take place at Range Regional Health Services. | ||
| MN | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Debra Boardman | ||||||||||||||
| President & CEO | 0 | 265308 | 0 | 0 | 0 | 2435 | 0 | 17996 | 0 | 6748 | 0 | 292487 | 0 | 0 |
| John Kritz | ||||||||||||||
| CFO | 188190 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 188190 | 0 | 0 | 0 |
| Vicky Korynta | ||||||||||||||
| COO | 194446 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 194446 | 0 | 0 | 0 |
| James E Hartert | ||||||||||||||
| VP Medical Director | 243655 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 243655 | 0 | 0 | 0 |
| Dr Kristin Fredrickson | ||||||||||||||
| Physician | 525852 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 525852 | 0 | 0 | 0 |
| Elizabeth Jones | ||||||||||||||
| Physician | 405735 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 405735 | 0 | 0 | 0 |
| Sandra Hanson | ||||||||||||||
| Physician | 401183 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 401183 | 0 | 0 | 0 |
| Lane meyer | ||||||||||||||
| Physician | 435955 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 435955 | 0 | 0 | 0 |
| Scott Stenstrom | ||||||||||||||
| Hospitalist | 413034 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 413034 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| CITY OF MINNEAPOLIS | ||||||||
| A | 616005375 | 60374VCH4 | 2008-11-12 | 8868000 | REFUNDED 2005B REFUNDING 2000A | 0 | 0 | 0 |
| CITY OF MINNEAPOLIS | ||||||||
| B | 616005375 | 60374VCH4 | 2008-10-29 | 7870000 | AMBULATORY SERVICES CONSTRUCTION | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Year Of Subst CompletionYearOfSubstCompletion |
|---|---|---|---|---|---|---|---|---|---|
| A | 8868000 | 919000 | 7821000 | 8740000 | 0 | 0 | 0 | 0 | |
| B | 7870000 | 69000 | 7801000 | 0 | 0 | 0 | 0 | 2011 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs | Engage Bond Counsel ContractsEngageBondCounselContracts |
|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
| B | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Michael Fay | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Board Member | Relationship |
| Amount Of Transaction | 15000 | AmountOfTransaction |
| Description Of Transaction | Insurance Commission | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | The Form 990 is reviewed by the Board of Directors before it is filed. | |
| Form 990, Part VI, Section B, line 12c | The board annually completes a conflict of interest statement. The CFO discloses the conflicts to the entire board. The CFO montors board motions to ensure disclosure of potential conflicts with votes. | |
| Form 990, Part VI, Section B, line 15 | Compensation is market based and based on data compiled by Fairview Health Services Corporate Human Resources. | |
| Form 990, Part VI, Section C, line 18 | The documents are available upon request in the organization's administration office. | |
| Form 990, Part VI, Section C, line 19 | The documents are available upon request in the organization's administration office. | |
| Form 990, Part XI, line 9: | Additional Liability Due to Health Insurance Reserves Additional Liability Third Party Payable Unusual circumstances due to EPIC -670,055. Defined Plan Valuation 449,286. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | EINEIN |
|---|---|---|---|---|---|---|
| Healthline LLC | ||||||
| 750 East 34th Street | Hibbing | MN | 55746 | Hospice Home Care | DE | |
| University Medical Center - Mesabi Auxiliary | ||||||
| 750 East 34th Street | Hibbing | MN | 55746 | Auxiliary | MN | 411452117 |
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fairview Health Services | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2450 Riverside Avenue | AddressLine1 |
| City | Minneapolis | City |
| Country | MN | Country |
| Postal Code | 55454 | PostalCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410991680 | EIN |
| Primary Activities | Health Care | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 170(B)(1)(A) | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mesaba Clinic | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3605 Mayfair Avenue | AddressLine1 |
| City | Hibbing | City |
| State | MN | State |
| ZIP Code | 55746 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411805715 | EIN |
| Primary Activity | Medical Services | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |