MILLE LACS HEALTH SYSTEM: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MILLE LACS HEALTH SYSTEM (EIN 41-0785161)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-14
- IRS object ID
- 201232279349303173
- Schema version
- 2010v3.4
- 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 I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T14:55:06-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410785161 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLE LACS HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MILL | NameControl |
| Phone | 3205322580 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET PO BOX A | AddressLine1 |
| City | ONAMIA | City |
| State | MN | State |
| ZIP Code | 563590800 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM NELSON | Name |
| Title | CEO | Title |
| Phone | 3205322580 | Phone |
| Date Signed | 2012-08-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WILLIAM NELSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET PO BOX A | AddressLine1 |
| City | ONAMIA | City |
| State | MN | State |
| ZIP Code | 563590800 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 36747081 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MLHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1953 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY HEALTH SERVICES TO RESIDENTS OF ONAMIA, MN AND THE SURROUNDING AREA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 552 | TotalNbrEmployees |
| Total Nbr Volunteers | 40 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 166453 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 246527 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 34713877 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 35951800 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 59254 | InvestmentIncomePriorYear |
| Investment Income Current Year | 74470 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 430789 | OtherRevenuePriorYear |
| Other Revenue Current Year | 474284 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 35370373 | TotalRevenuePriorYear |
| Total Revenue Current Year | 36747081 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 60000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 60000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 19419413 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20388123 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 2280 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14224526 | OtherExpensePriorYear |
| Other Expenses Current Year | 14267318 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 33703939 | TotalExpensesPriorYear |
| Total Expenses Current Year | 34715441 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1666434 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2031640 | RevenuesLessExpensesCY |
| Total Assets BOY | 28768186 | TotalAssetsBOY |
| Total Assets EOY | 31484361 | TotalAssetsEOY |
| Total Liabilities BOY | 15823667 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16537096 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 12944519 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14947265 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO ASSIST THOSE RESIDING IN AND VISITING THE MILLE LACS AREA IN ACHIEVING AND MANTAINING OPTIMAL HEALTH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 29936799 | Expense |
| Grants | 60000 | Grants |
| Revenue | 35951800 | Revenue |
| Description | MILLE LACS HEALTH SYSTEM (MLHS) IS A RURAL HEALTH SYSTEM LOCATED IN ONAMIA, MN, 80 MILES NORTH OF THE TWIN CITIES ON THE SOUTH SHORE OF LAKE MILLE LACS. OUR SYSTEM INCLUDES A 25-BED ACUTE CARE HOSPITAL, A 57-BED LONG-TERM CARE FACILITY, A 10-BED SENIOR CARE FACILITY, HOME CARE, HOSPICE, A BLS AND PART-TIME ALS AMBULANCE SERVICE, AS WELL AS AN ATTACHED MEDICAL CLINIC. MLHS ALSO OPERATES CLINICS IN THE TOWNS OF ISLE, HILLMAN, GARRISON AND MILACA. OUR MEDICAL STAFF ALSO PROVIDES COVERAGE TO THE NE-LA-SHING CLINIC ON THE NEARBY MILLE LACS RESERVATION. THE HEALTH SYSTEM IS ORGANIZED AS A 501(C)(3) NONPROFIT CORPORATION. DUE TO THE LACK OF AVAILABLE HEALTHCARE OPTIONS IN THIS CENTRAL MINNESOTA REGION, THE FEDERAL GOVERNMENT HAS DESIGNATED THIS COMMUNITY AS A MEDICALLY UNDERSERVED AREA IN TERMS OF PRIMARY CARE CLINICS. THE REMOTENESS OF HEALLHCARE SERVICES TO THE MILLE LACS COMMUNITIES IN THE 1950'S PROMPTED AN AREA-WIDE COMMUNITY EFFORT TO BUILD A HOSPITAL. THE HOSPITAL WAS COMPLETED IN 1956 AND, FIVE YEARS LATER A NURSING HOME WAS BUILT ADJACENT TO IT. OVER THE YEARS, THE FACILITIES HAVE BEEN EXPANDED AND MODERNIZED AND RENAMED SEVERAL TIMES. IN 1995, AN AMBITIOUS BUILDING PROJECT AND INTEGRATION EFFORT, WHICH INCLUDED A NEW HOSPITAL EMERGENCY ROOM, REHABILITATION CENTER, AND CLINIC SPACE WERE COMPLETED. THIS BUILDING PROJECT WAS MADE POSSIBLE THROUGH NEARLY A HALF MILLION DOLLARS WHICH WERE RAISED LOCALLY. IN 2001, A MULTI-MILLION DOLLAR EXPANSION AND RENOVATION PROJECT WAS STARTED TO FURTHER UPGRADE THE HOSPITAL AND LONG-TERM CARE SERVICES AND POSITION US TO MEET THE GROWING HEALTHCARE NEEDS OF THE AREA. IN 2010, AN EXPANSION PROJECT INCLUDED NEW SPACE IN THE BASEMENTE OF LAKE SONG ASSISTED LIVING; EXPANSION AND REMODEL OF THE ONAMIA CLINIC; NEW PHARMACY DEPARTMENT; AND A NEW OUT-PATIENT DEPARTMENT.MILLE LACS HEALTH SYSTEM SERVES A PERMANENT POPULATION OF BETWEEN 12,000 AND 15,000, INCLUDING RESIDENTS OF THE MILLE LACS RESERVATION. BECAUSE OF THE RECREATIONAL FEATURES OF THE MILLE LACS AREA, MLHS ALSO SERVES A NUMBER OF SEASONAL RESIDENTS. IT IS ESTIMATED THAT DURING THE BUSY SUMMER AND HOLIDAY WEEKENDS THERE ARE UP TO AN ADDITIONAL 25,000 PEOPLE IN THE AREA. THIS NUMBER IS BASED ON STATISTICS FROM LOCAL RESORTS, MOTELS, AND CAMPGROUNDS. THE CLOSEST ACUTE CARE FACILITY IS 38 MILES AWAY IN PRINCETON. THE CLOSEST TERTIARY CARE FACILITY IS 55 MILES AWAY IN ST. CLOUD. THE CLOSEST SECONDARY LEVEL IS 50 MILES AWAY IN BRAINERD. MLHS IS THE ONLY PROVIDER OF ACUTE CARE WITHIN OUR PRIMARY SERVICE AREA OF ONAMIA, HILLMAN, ISLE, GARRISON AND WAHKON, WHICH INCLUDES THE MILLE LACS RESERVATION.MILLE LACS HEALTH SYSTEM ALSO SERVES PATIENTS OUTSIDE THE PRIMARY SERVICE AREA. THE SECONDARY SERVICE AREA INCLUDES MORA, BOCK, MILACA, AND OGILVIE. | Description |
| Total Program Service Expense | 29936799 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | 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 | 0 | 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 | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 75 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 552 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | 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 | JOHN UNZEN CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3205322580 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET PO BOX A | AddressLine1 |
| City | ONAMIA | City |
| State | MN | State |
| ZIP Code | 563590800 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| MARK TADYCH | ||||||||
| BOARD CHAIRPERSON | 8.00 | X | X | 4800 | 0 | 0 | ||
| KEVIN ANDERSON | ||||||||
| VICE-CHAIRPERSON | 2.00 | X | X | 780 | 0 | 0 | ||
| JUDY WAYTASHEK | ||||||||
| TREASURER | 2.00 | X | X | 660 | 0 | 0 | ||
| DIANE GIBAS | ||||||||
| SECRETARY | 2.00 | X | X | 660 | 0 | 0 | ||
| STEVE LONG | ||||||||
| BOARD MEMBER | 2.00 | X | 450 | 0 | 0 | |||
| BECKY HOULE | ||||||||
| BOARD MEMBER | 2.00 | X | 750 | 0 | 0 | |||
| FR KERMIT HOLL OSC | ||||||||
| BOARD MEMBER | 2.00 | X | 570 | 0 | 0 | |||
| GAIL KULICK-JACKSON | ||||||||
| BOARD MEMBER | 2.00 | X | 210 | 0 | 0 | |||
| ARDEN VIRNIG | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | X | 177520 | 0 | 7630 | |||
| MAGGIE LARSON | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | X | 160266 | 0 | 24092 | |||
| WILLIAM NELSON | ||||||||
| CEO | 40.00 | X | 248356 | 0 | 15203 | |||
| JOHN UNZEN | ||||||||
| CFO | 40.00 | X | 141485 | 0 | 5967 | |||
| TOM BRACKEN | ||||||||
| PHYSICIAN - KEY EMPLOYEE | 40.00 | 198831 | 0 | 25470 | X | |||
| RODNEY HAYES | ||||||||
| PHYSICIAN | 40.00 | 169353 | 0 | 24402 | X | |||
| FERN GERSHONE | ||||||||
| KEY EMPLOYEE | 40.00 | 129053 | 0 | 5482 | X | |||
| KIM KUCERA | ||||||||
| COO | 40.00 | 141174 | 0 | 21776 | X | |||
| SHARON GOSSETT | ||||||||
| SURGEON | 40.00 | 512723 | 0 | 25591 | X | |||
| CATHY DONOVAN | ||||||||
| PHYSICIAN | 40.00 | 168966 | 0 | 20035 | X | |||
| PETER LINDBLOOM | ||||||||
| DIRECTOR OF ER | 40.00 | 153215 | 0 | 23923 | X | |||
| MARK MARSHALL | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 137459 | 0 | 12884 | X | |||
| ROGER BOETTCHER | ||||||||
| CHIEF OF STAFF | 40.00 | 191741 | 0 | 26216 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2409969 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 233189 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | 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 |
|---|---|---|---|---|---|
| ANDERSON BUILDERS INC | |||||
| 4220 PARK GLEN ROAD | ST LOUIS PARK | MN | 55416 | BUILDER/REMODLER | 1481245 |
| CMDI | |||||
| 150 10TH STREET NW | MILACA | MN | 56353 | MRI/RADIOLGY | 1269301 |
| JUSTIN TOWNE CENTRAL MN ANESTHESIA | |||||
| 9527 330TH | ONAMIA | MN | 56359 | CRNA | 492298 |
| BEHAVIORAL HEALTH CONCEPTS INC | |||||
| 305 CALLE VILLARIO | SAN CLEMENTE | CA | 92672 | COUNSELING SENIOR CARE | 404661 |
| HEALTHCARE MANAGEMENT SYSTEMS INC | |||||
| 2739 MOMENTUM PLACE | CHICAGO | IL | 60689 | HEALTHCARE SOFTWARE/MAINTENANCE SERVICES | 376759 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Related Organizations | 84521 | RelatedOrganizations |
| Government Grants | 104783 | GovernmentGrants |
| All Other Contributions | 57223 | AllOtherContributions |
| Total Contributions | 246527 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE | 621110 | 34718656 | 34718656 |
| JOINT VENTURE INCOME | 900099 | 618538 | 618538 |
| ASSISTED LIVING | 623000 | 483551 | 483551 |
| CLINIC REVENUE | 900099 | 99496 | 99496 |
| THERAPY REVENUE | 900099 | 31559 | 31559 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 35951800 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 72593 | TotalRevenueColumn |
| Exclusion | $72,593 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 39916 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 39916 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 39916 | TotalRevenueColumn |
| Exclusion | $39,916 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1877 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1877 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1877 | TotalRevenueColumn |
| Exclusion | $1,877 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 87367 | GrossSalesOfInventory |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 87367 | TotalRevenueColumn |
| Exclusion | $87,367 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MEALS REVENUE | 900099 | 298118 | $298,118 |
| MISCELLANEOUS | 900099 | 43893 | $43,893 |
| DISCOUNTS & REBATES | 900099 | 4990 | $4,990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 347001 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 36747081 | TotalRevenueColumn |
| Related Or Exempt Function Income | 35951800 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $548,754 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60000 | Total |
| Program Services | 60000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 755368 | Total |
| Program Services | 344599 | ProgramServices |
| Management And General | 410769 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13399640 | Total |
| Program Services | 12292852 | ProgramServices |
| Management And General | 1104508 | ManagementAndGeneral |
| Fundraising | 2280 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 373744 | Total |
| Program Services | 345304 | ProgramServices |
| Management And General | 28440 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4750955 | Total |
| Program Services | 4506422 | ProgramServices |
| Management And General | 244533 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1108416 | Total |
| Program Services | 984840 | ProgramServices |
| Management And General | 123576 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36431 | Total |
| Management And General | 36431 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194217 | Total |
| Management And General | 194217 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3902400 | Total |
| Program Services | 3277600 | ProgramServices |
| Management And General | 624800 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165181 | Total |
| Program Services | 1881 | ProgramServices |
| Management And General | 163300 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 948579 | Total |
| Program Services | 570063 | ProgramServices |
| Management And General | 378516 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 529622 | Total |
| Program Services | 501125 | ProgramServices |
| Management And General | 28497 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 202903 | Total |
| Program Services | 152019 | ProgramServices |
| Management And General | 50884 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8344 | Total |
| Management And General | 8344 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 676886 | Total |
| Program Services | 615232 | ProgramServices |
| Management And General | 61654 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2149191 | Total |
| Program Services | 1584815 | ProgramServices |
| Management And General | 564376 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 309521 | Total |
| Program Services | 238409 | ProgramServices |
| Management And General | 71112 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 2039857 | 2039857 | |
| BAD DEBT EXPENSE | 1525036 | 1525036 | |
| TAXES | 631346 | 247193 | 384153 |
| FOOD | 387997 | 387997 | |
| REPAIRS & MAINTENANCE | 185274 | 172252 | 13022 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 374533 | Total |
| Program Services | 89303 | ProgramServices |
| Management And General | 285230 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34715441 | Total |
| Program Services | 29936799 | ProgramServices |
| Management And General | 4776362 | ManagementAndGeneral |
| Fundraising | 2280 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7164814 | BOY |
| EOY | 21098 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 238000 | BOY |
| EOY | 8974753 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6138589 | BOY |
| EOY | 6031865 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 204968 | BOY |
| EOY | 185165 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 296657 | BOY |
| EOY | 346175 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 642706 | BOY |
| EOY | 711374 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 34903242 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 21242684 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12693668 | BOY |
| EOY | 13660558 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1293269 | BOY |
| EOY | 1463926 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 95515 | BOY |
| EOY | 89447 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28768186 | BOY |
| EOY | 31484361 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2522912 | BOY |
| EOY | 2122213 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10446453 | BOY |
| EOY | 10075033 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2399302 | BOY |
| EOY | 3703850 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 455000 | BOY |
| EOY | 636000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15823667 | BOY |
| EOY | 16537096 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12886775 | BOY |
| EOY | 14918416 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57744 | BOY |
| EOY | 28849 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12944519 | BOY |
| EOY | 14947265 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28768186 | BOY |
| EOY | 31484361 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2031640 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -28895 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 365798 | OtherCostOrOtherBasis |
| Book Value | 365798 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21937792 | OtherCostOrOtherBasis |
| Depreciation | 12497041 | Depreciation |
| Book Value | 9440751 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 924384 | OtherCostOrOtherBasis |
| Depreciation | 615628 | Depreciation |
| Book Value | 308756 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10827077 | OtherCostOrOtherBasis |
| Depreciation | 8130015 | Depreciation |
| Book Value | 2697062 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 848191 | OtherCostOrOtherBasis |
| Book Value | 848191 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13660558 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO THIRD PARTY PAYORS | Description |
| Amount | $636,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 636000 | TotalOfAmounts |
| Total Revenue | 36747081 | TotalRevenue |
| Total Expenses | 34715441 | TotalExpenses |
| Excess Or Deficit For Year | 2031640 | ExcessOrDeficitForYear |
| Other | -$28,895 | OtherAmount |
| Total Adjustments | -28895 | TotalAdjustments |
| Excess Or Deficit Per FS | 2002745 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 36426084 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 36426084 | RevenueSubtotal |
| Other Revenues Not Included | 320997 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 320997 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 36747081 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 34715440 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 34715440 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 34715440 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | INCOME TAXES THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE TAX RETURNS FOR THE TAX YEARS 2008 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTIONS -28,895. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | UNRESTRICTED CONTRIBUTIONS 144,202. INTEREST INCOME 72,012. GRANT INCOME 104,783. |
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 |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| 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 | 774187 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 774187 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02330 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5508062 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3923200 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1584862 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04780 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6282249 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3923200 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2359049 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07110 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 35255 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 35255 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 165703 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15919 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 149784 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13639 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13639 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 214597 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15919 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 198678 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00600 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6496846 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3939119 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2557727 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07710 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $981,241 | BadDebtExpenseAmount |
| Amount Attributable To | 335192 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4658325 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 10922091 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -6263766 | 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 | MILLE LACS HEALTH SYSTEM HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET | AddressLine1 |
| City | ONAMIA | City |
| State | MN | State |
| ZIP Code | 563590800 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 7 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (7 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| MLHS - LONG TERM CARE | ||||
| 200 NORTH ELM ST | ONAMIA | MN | 56359 | SKILLED NURSING FACILITY |
| MLHS FAMILY CLINIC - GARRISON | ||||
| 27378 STATE HWY 18 | GARRISON | MN | 56450 | MEDICAL CLINIC |
| MLHS FAMILY CLINIC - ISLE | ||||
| 375 WEST ISLE ST | ISLE | MN | 56342 | MEDICAL CLINIC |
| MLHS FAMILY CLINIC - ONAMIA | ||||
| 200 NORTH ELM ST | ONAMIA | MN | 56359 | MEDICAL CLINIC |
| MLHS FAMILY CLINIC - HILLMAN | ||||
| 26362 370TH AVE | HILLMAN | MN | 56338 | MEDICAL CLINIC |
| MLHS HOME CARE AND HOSPICE | ||||
| 200 NORTH ELM ST | ONAMIA | MN | 56359 | MEDICAL CLINIC |
| MLHS CHIROPRACTIC AND PHYSICAL THERAPY | ||||
| 1010 5TH STREET SE | MILACA | MN | 56353 | CHIROPRACTIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: THE FEDERAL POVERTY INCOME GUIDELINES PROVIDE THE INITIAL FRAMEWORK TO DETERMINE THE INDIVIDUAL'S ABILITY TO PAY. INDIVIDUALS WITH INCOME AND ASSETS EQUAL TO OR LESS THAN THE FEDERAL POVERTY INCOME GUIDELINES, WITH NO OTHER AVAILABLE ASSETS MUST BE EVALUATED TO SEE IF THE PATIENT FIRST QUALIFIES FOR ASSISTANCE FROM ANY FEDERAL, STATE, OR LOCAL COUNTY PROGRAMS SUCH AS MA. A REASONABLE PAYMENT SCHEDULE OVER A ONE OR TWO YEAR PERIOD WILL BE DETERMINED IN THE INTERVIEW PROCESS. THE PORTION THAT WILL BE WRITTEN OFF SHOULD THEN BE CLASSIFED AS A CHARITY DISCOUNT. INDIVIDUALS WITHIN TWO (2) TIMES THE FEDERAL POVERTY GUIDELINES MAY ALSO HAVE SOME MEDICAL INSURANCE COVERAGE. THE PATIENT DEDUCTABLE AND NONCOVERED SERVICES MAY BE LARGE ENOUGH THAT THE INDIVIDUAL IN INCAPABLE OF PAYING OFF WITHIN A 1-2 YEAR PERIOD. THEREFORE, THIS UNPAYABLE AMOUNT BY THE PATIENT MAY BE CLASSIFED AS CHARITY DISCOUNT. | ||
| PART I, LINE 7: THE COSTS INCLUDED IN PART 1, LINES 7A AND 7B WERE DERIVED BY USING THE COST TO CHARGE RATIO CALCULATED USING WORKSHEET 2 AND THEN APPLIED AGAINST INTERNALLY DEVELOPED NUMBERS. THE COSTS INCLUDED IN PART 1, LINES 7E, 7F AND 7I WERE ACTUAL COSTS TRACKED BY THE HEALTH SYSTEM IN THEIR FINANCIAL PROCESS. | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1525036. | ||
| PART III, LINE 4: A COST-TO-CHARGE RATIO WAS USED TO REPORT BAD DEBT FIGURES. THE COST TO CHARGE RATIO WAS DERIVED FROM THE IRS INSTRUCTIONS FOR SCHEUDLE H, WORKSHEET 2. AMOUNTS ON LINE 3 WERE CALCULATED MANUALLY BY REVIEWING ALL BAD DEBT CHARGES FOR PATIENTS THAT HAD ANY MEDICAL ASSISTANCE OR PMAP/MNCARE COVERAGE AND GUARANTOR NOTES REGARDING CHARITY CARE. MOST OF THE VISITS INCLUDED IN THE TOTAL WERE FOR PATIENTS THAT MAY HAVE QUALIFIED FOR CHARITY CARE, BUT THEY CHOOSE NOT TO APPLY OR COMPLETE THE APPLICATION. MLHS DOES OFFER ASSISTANCE IN THE PREPARATION OF THE CHARITY CARE FORMS.FINANCIAL STATEMENT DISCLOSUREPATIENT AND RESIDENT SERVICE REVENUE IS RECORDED AT THE ORGANIZATION'S ESTABLISHED RATES WHEN THE SERVICE IS PROVIDED, WITH CONTRACTUAL ADJUSTMENTS DEDUCTED TO ARRIVE AT NET PATIENT AND RESIDENT SERVICE REVENUE. TOTAL CONTRACTUAL ADJUSTMENTS FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND 2010 WERE APPROXIMATELY $24,001,000 AND $20,405,000, RESPECTIVELY. THE ORGANIZATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES (CHARITY CARE) TO PATIENTS WHO MEET CERTAIN CRITERIA. CHARITY CARE AMOUNTS ARE NOT REPORTED AS REVENUE, AS THE ORGANIZATION DOES NOT PURSUE COLLECTION.PATIENT ACCOUNTS RECEIVABLE, WHERE A THIRD-PARTY PAYOR IS RESPONSIBLE FOR PAYING THE AMOUNT, ARE CARRIED AT A NET AMOUNT DETERMINED BY THE ORIGINAL CHARGE FOR THE SERVICES PROVIDED, LESS AN ESTIMATE MADE FOR CONTRACTUAL ADJUSTMENTS OR DISCOUNTS PROVIDED TO THIRD-PARTY PAYORS.PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICES PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS, AND BY CONSIDERING THE PATIENTS FINANCIAL HISTORY AND CREDIT HISTORY AND CURRENT ECONOMIC CONDITIONS. TOTAL ALLOWANCE FOR DOUBTFUL ACCOUNTS AT SEPTEMBER 30, 2011 AND 2010 WERE APPROXIMATELY $2,124,000 AND $1,802,000, RESPECTIVELY. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED.THE ORGANIZATION HAS AGREEMENTS WITH THIRD-PARTY PAYORS WHICH PROVIDE FOR REIMBURSEMENT TO THE ORGANIZATION AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. THE PRIMARY PAYORS ARE MEDICARE, MEDICAID AND BLUE CROSS BLUE SHIELD.THE ORGANIZATION HAS A CONTRACT WITH MEDICARE AS A CRITICAL ACCESS HOSPITAL (CAH). UNDER CAH STATUS, HOSPITAL SERVICES PROVIDED TO MEDICARE BENEFICIARIES ARE PAID BASED UPON A COST-REIMBURSEMENT METHODOLOGY, WITH TENTATIVE RATES PAID DURING THE YEAR ON ALL INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF AN ANNUAL COST REPORT.BLUE CROSS BLUE SHIELD REIMBURSEMENT IS BASED ON THE ORGANIZATION'S ESTABLISHED RATES. MEDICAL ASSISTANCE REIMBURSEMENT FOR HOSPITAL PATIENTS IS BASED ON PROSPECTIVELY ESTABLISHED RATES. THE RATES CHARGED TO MEDICAL ASSISTANCE AND PRIVATE-PAY RESIDENTS AT THE NURSING HOME ARE ESTABLISHED IN ACCORDANCE WITH RULES OF THE STATE OF MINNESOTA.RETROACTIVELY CALCULATED CONTRACTUAL ADJUSTMENTS ARISING UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE RECOGNIZED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.THE LAWS AND REGULATIONS UNDER WHICH THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS OPERATE ARE COMPLEX, SUBJECT TO FREQUENT CHANGE AND SUBJECT TO INTERPRETATION. AS PART OF OPERATING UNDER THESE PROGRAMS, THERE IS A POSSIBILITY THAT GOVERNMENTAL AUTHORITIES MAY REVIEW THE ORGANIZATION'S COMPLIANCE WITH THESE LAWS AND REGULATIONS. SUCH REVIEW MAY RESULT IN ADJUSTMENTS TO REIMBURSEMENT PREVIOUSLY RECEIVED AND SUBJECT THE ORGANIZATION TO FINES AND PENALTIES. ALTHOUGH NO ASSURANCES CAN BE GIVEN, MANAGEMENT BELIEVES THEY HAVE COMPLIED WITH THE REQUIREMENTS OF THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS. | ||
| PART III, LINE 8: THE MEDICARE SHORT-FALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE: (1) IT PROVIDES SERVICES TO A SIGNIFICANT PORTION OF OUR SERVICE POPULATION AT A NEGATIVE MARGIN (2) THE HOSPITAL WOULD DISCONTINUE PROVIDING SERVICES TO MEDICARE PATIENTS IF THE DECISION WERE SOLEY FINANCIAL (3) THERE IS A COMMUNITY NEED TO PROVIDE THESE SERVICES AND (4) IF THE HOSPITAL DID NOT PROVIDE THESE SERVICES, THEY WOULD BECOME THE OBLIGATION OF THE GOVERNMENT. THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III WERE DERIVED FROM THE MEDICARE COST REPORT FILED BY THE HEALTH SYSTEM. | ||
| PART VI, LINE 2: MILLE LACS HEALTH SYSTEM ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY THROUGH THE ORGANIZATION OF COMMUNITY MEETINGS - FEEDBACK FORUMS. THE ORGANIZERS PROVIDE CONSTANT FEEDBACK OF COMMUNITY NEEDS. THERE ARE COMMUNITY FOCUS GROUPS AND HOSPITAL STAFF ATTENDANCE AT VARIOUS CLUB MEETINGS TO PROVIDE HEALTH INFORMATION AND GUIDANCE ON HOW TO ACCESS TO THE HOSPITALS SERVICES. | ||
| PART VI, LINE 3: ELIGIBILITY FOR ASSISTANCE INFORMATION IS ON THE BILLING STATEMENTS. THE HEALTH SYSTEM PROVIDES ARTICLE NEWSLETTERS AND COMMUNITY OUTREACH PROGRAMS ON SUCH PROGRAMS AVAILABLE TO THE PUBLIC. AN ASSISTANCE INFORMATION SHEET IS PROVIDED TO THE PATIENT OR REPRESENTATIVE AT THE TIME OF THE SERVICE OR AT A SCHEDULED MEETING FOR ELIGIBILITY. | ||
| PART VI, LINE 4: MILLE LACS HEALTH SYSTEM IS LOCATED 80 MILES NORTH OF THE MINNEAPOLIS MN AREA IN CENTRAL MINNESOTA. THE HEALTH SYSTEM SERVES THE PREDOMINATELY RURAL AREA OF MILLE LACS COUNTY AND PORTIONS OF MORRISON, AITKIN, CROW WING AND KANABEC COUNTIES, PLUS THE MILLE LACS OJIBWE INDIAN RESERVATION. THE MILLE LACS PRIMARY SERVICE AREA INCLUDES 15,000 TO 18,000 YEAR ROUND RESIDENTS WITH THE POPULATION DOUBLING DURING THE PEAK TOURIST SEASON. PERSONS LIVING BELOW THE POVERTY LEVEL IS IN MILLE LACS COUNTY IS 13.4% FROM THE US CENSUS. THE DEMOGRAPHIC AN SOCIOECONOMIC PROFILE COMMON TO OUR RURAL COMMUNITY ALSO INFLUENCES THE DEMANDS ON OUR HEALTHCARE SYSTEM. RURAL AREAS IN GENERAL HAVE GREATER CONCENTRATIONS OF ELDERLY PEOPLE THAN DO URBAN AREAS. AN OLDER POPLULATION IS MORE LIKELY TO HAVE CHRONIC HEALTHCARE NEEDS, WHICH CAN PLACE A HEAVY BURDEN ON COMMUNITIES THAT ALREADY FACE PROVIDER SHORTAGES. | ||
| PART VI, LINE 6: MILLE LACS HEALTH SYSTEM PROVIDES EDUCATIONAL HEALTH FAIRS,COMMUNITY MEETINGS ON HEALTH PROBLEMS, DIAGNOSIS AND PREVENTION METHODS. PART OF OUR MISSION STATEMENT IS TO ASSIST THOSE RESIDING IN AND VISITING THE MILLE LACS AREA IN ACHIEVING AND MAINTAINING OPTIMAL HEALTH. THE HEALTH SYSTEM PROVIDES PASTORAL CARE TO PATIENTS UPON REQUEST-FROM OUR AREA CHURCHES CLERGY. WE SEND OUT QUARTERLY COMMUNITY HEALTH INFORMATION NEWS LETTERS. WE PROVIDE FREE BLOOD PRESSURE TESTING PROGRAMS. | ||
| MN | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLE LACS AREA HEALTH FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET PO BOX A | AddressLine1 |
| City | ONAMIA | City |
| State | MN | State |
| ZIP Code | 56359 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 743155412 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 60000 | AmountOfCashGrant |
| Purpose Of Grant | GENERAL OPERATING SUPPORT. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE HEALTH SYSTEM'S ONLY GRANT WAS TO A RELATED FOUNDATION UNDER COMMON MANAGEMENT. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| 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 | 0 | 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 (11 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ARDEN VIRNIG | |||||||||||||
| 152524 | 0 | 101 | 0 | 24895 | 0 | 7075 | 0 | 555 | 0 | 185150 | 0 | 0 | 0 |
| MAGGIE LARSON | |||||||||||||
| 144163 | 0 | 101 | 0 | 16002 | 0 | 6398 | 0 | 17694 | 0 | 184358 | 0 | 0 | 0 |
| WILLIAM NELSON | |||||||||||||
| 184097 | 0 | 52481 | 0 | 11778 | 0 | 8459 | 0 | 6744 | 0 | 263559 | 0 | 0 | 0 |
| TOM BRACKEN | |||||||||||||
| 163696 | 0 | 101 | 0 | 35034 | 0 | 6879 | 0 | 18591 | 0 | 224301 | 0 | 0 | 0 |
| RODNEY HAYES | |||||||||||||
| 151315 | 0 | 101 | 0 | 17937 | 0 | 6707 | 0 | 17695 | 0 | 193755 | 0 | 0 | 0 |
| KIM KUCERA | |||||||||||||
| 132890 | 0 | 101 | 0 | 8183 | 0 | 5621 | 0 | 16155 | 0 | 162950 | 0 | 0 | 0 |
| SHARON GOSSETT | |||||||||||||
| 250016 | 0 | 101 | 0 | 262606 | 0 | 9800 | 0 | 15791 | 0 | 538314 | 0 | 0 | 0 |
| CATHY DONOVAN | |||||||||||||
| 149659 | 0 | 101 | 0 | 19206 | 0 | 6114 | 0 | 13921 | 0 | 189001 | 0 | 0 | 0 |
| PETER LINDBLOOM | |||||||||||||
| 147267 | 0 | 101 | 0 | 5847 | 0 | 6115 | 0 | 17808 | 0 | 177138 | 0 | 0 | 0 |
| MARK MARSHALL | |||||||||||||
| 132506 | 0 | 101 | 0 | 4852 | 0 | 5438 | 0 | 7446 | 0 | 150343 | 0 | 0 | 0 |
| ROGER BOETTCHER | |||||||||||||
| 152421 | 0 | 101 | 0 | 39219 | 0 | 7624 | 0 | 18592 | 0 | 217957 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF ONAMIA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 416005437 | IssuerEIN |
| Date Issued | 2003-06-24 | DateIssued |
| Issue Price | 4500000 | IssuePrice |
| Description Of Purpose | NURSING HOME FACILITY | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 1097582 | AmountRetired |
| Total Proceeds | 4500000 | TotalProceeds |
| Issuance Costs From Proceeds | 40431 | IssuanceCostsFromProceeds |
| Capital Expenditures | 4459569 | CapitalExpenditures |
| Year Of Subst Completion | 2005 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KEVIN ANDERSON | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | KEVIN ANDERSON IS THE VICE CHAIRMAN OF THE BOARD OF DIRECTORS OF MLHS | Relationship |
| Amount Of Transaction | 139476 | AmountOfTransaction |
| Description Of Transaction | MILLE LACS MESSENGER, THE LOCAL NEWSPAPER, PROVIDES ADVERTISING FOR THE MILLE LACS HEALTH SYSTEM. THE MILLE LACS MESSENGER IS OWNED BY KEVIN ANDERSON. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WILL BE PRESENTED AT A BOARD MEETING FOR APPROVAL BEFORE FILING THE TAX RETURN. | |
| EACH DIRECTOR/OFFICER OF MLHS SHALL COMPLETE AND SIGN A CONLFICT OF INTEREST QUESTIONNARIE UPON APPOINTMENT AND THEREAFTER AT THE TIME OF EACH ANNUAL MEETING. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO AND COMPLIANCE OFFICER. EACH DIRECTOR/OFFICER OF MLHS SHALL FULLY DISCLOSE ANY CONFLICTS OF INTERESTS. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER/OFFICER MAY BE ASKED TO STEP DOWN. | FORM 990, PART VI, SECTION B, LINE 12C | |
| CEO COMPENSATION IS EVALUATED BY THE BOARD OF DIRECTORS. COMPARABILITY DATA FROM OTHER AREA FACILITIES IS USED ALONG WITH AN EXECUTIVE SALARY SURVEY TO DETERMINE COMPENSATION FOR TOP MANAGEMENT OFFICIALS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE HEALTH SYSTEM'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| OVERLAP OF BOARD MEMBERS | KEVIN ANDERSON AND MAGGIE LARSON ALSO SERVE ON THE BOARD OF DIRECTORS OF MILLE LACS HEALTH SYSTEM FOUNDATION. EACH BOARD MEMBER SPENDS APPROXIMATELY THE SAME AMOUNT OF TIME SERVING EACH OF THE RELATED ORGANIZATIONS, FOR A TOTAL OF 2 HOUR PER WEEK. | FORM 990, PART VII, SECTION A |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET ASSETS RELEASED FROM RESTRICTIONS -28,895. TOTAL TO FORM 990, PART XI, LINE 5: -28,895. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLE LACS AREA HEALTH FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET PO BOX A | AddressLine1 |
| City | ONAMIA | City |
| State | MN | State |
| ZIP Code | 56359 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 743155412 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 7 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| 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 | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |