LIFECARE MEDICAL CENTER: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- LIFECARE MEDICAL CENTER (EIN 41-1804205)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201102279349301215
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T09:14:58-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5601 Green Valley Drive Ste 700 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 554371145 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411804205 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LifeCare Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LIFE | NameControl |
| Phone | 2184632500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Delmore Drive | AddressLine1 |
| City | Roseau | City |
| State | MN | State |
| ZIP Code | 56751 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Keith Okeson | Name |
| Title | CEO/President | Title |
| Phone | 2184632500 | Phone |
| Date Signed | 2011-08-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kim Hunwardsen CPA | Name |
| Phone | 9529446166 | Phone |
| Date Prepared | 2011-08-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Keith Okeson | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Delmore Drive | AddressLine1 |
| City | Roseau | City |
| State | MN | State |
| ZIP Code | 56751 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 36274832 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.lifecaremedicalcenter.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | Promotion of Health | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 526 | TotalNbrEmployees |
| Total Nbr Volunteers | 300 | TotalNbrVolunteers |
| Total Gross UBI | 1981 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 78 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 130354 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 451009 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 36183210 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 35090595 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 699926 | InvestmentIncomePriorYear |
| Investment Income Current Year | 447121 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -8081 | OtherRevenuePriorYear |
| Other Revenue Current Year | -1171 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 37005409 | TotalRevenuePriorYear |
| Total Revenue Current Year | 35987554 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 4500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 3000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 18881597 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19494452 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13270981 | OtherExpensePriorYear |
| Other Expenses Current Year | 13260272 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 32157078 | TotalExpensesPriorYear |
| Total Expenses Current Year | 32757724 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4848331 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3229830 | RevenuesLessExpensesCY |
| Total Assets BOY | 48389278 | TotalAssetsBOY |
| Total Assets EOY | 50605471 | TotalAssetsEOY |
| Total Liabilities BOY | 12827607 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11813970 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 35561671 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 38791501 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide care for a healthy life | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 27431575 | Expense |
| Grants | 3000 | Grants |
| Revenue | 35088614 | Revenue |
| Description | LifeCare Medical Center operates a 25-bed acute care hospital, including a 64-bed nursing facility, home health, hospice, and public health in Roseau, Minnesota. The organization also operates a 50-bed nursing home in Greenbush, Minnesota. The purpose of the organization is to own, maintain, and operate a hospital, nursing homes, furnish medical and surgical care to the sick, infirmed, or injured.Acute Care Hospital (Inpatient and Outpatient)Inpatient days: 2,142Outpatient visits: 33,626Long Term CareLifeCare Roseau Manor Resident Days: 22,560LifeCare Greenbush Manor Resident Days: 16,676Home Health/Public Health Visits: 15,922Hospice Clients Served: 24To fulfill its mission of community service, LifeCare Medical Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. The amount of charges foregone, based on established rates, was $428,929 for the year ended September 30, 2010. | Description |
| Total Program Service Expense | 27431575 | 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 | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| 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 |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | 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 | 75 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 526 | 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 |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | 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 | Cathy Huss | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2184634763 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Delmore Drive | AddressLine1 |
| City | Roseau | City |
| State | MN | State |
| ZIP Code | 56751 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Cory Vatnsdal | |||||||
| Chair | 1.00 | X | X | 2025 | 0 | 0 | |
| Carolyn Eeg | |||||||
| Vice Chair | 1.00 | X | X | 600 | 0 | 0 | |
| Carmen Przekwas | |||||||
| Secretary | 1.00 | X | X | 1875 | 0 | 0 | |
| Therese McBride | |||||||
| Treasurer | 1.00 | X | X | 975 | 0 | 0 | |
| Brenda Sather | |||||||
| Trustee | 1.00 | X | 1050 | 0 | 0 | ||
| Ralph Herseth MD | |||||||
| Trustee | 1.00 | X | 1050 | 0 | 0 | ||
| Paul Everson | |||||||
| Trustee | 1.00 | X | 975 | 0 | 0 | ||
| Jon Johnson | |||||||
| Trustee | 1.00 | X | 900 | 0 | 0 | ||
| Mark Wilson | |||||||
| Trustee | 1.00 | X | 1200 | 0 | 0 | ||
| Pete Granger | |||||||
| Trustee | 1.00 | X | 900 | 0 | 0 | ||
| Steve Haugen | |||||||
| Trustee | 1.00 | X | 750 | 0 | 0 | ||
| Pete Helgeson | |||||||
| Trustee | 1.00 | X | 600 | 0 | 0 | ||
| Chuck Lindner | |||||||
| Trustee | 1.00 | X | 1050 | 0 | 0 | ||
| Cathy Huss | |||||||
| CFO | 40.00 | X | 142414 | 0 | 29930 | ||
| Keith Okeson | |||||||
| CEO/President | 40.00 | X | 186430 | 0 | 39837 | ||
| Gordon Streiff | |||||||
| Pharmacy Director | 40.00 | 121291 | 0 | 34583 | X | ||
| Sue Lisell | |||||||
| Senior Leader | 40.00 | 142747 | 0 | 17129 | X | ||
| Shannon D Carlson | |||||||
| Senior Leader | 40.00 | 103902 | 0 | 27836 | X | ||
| Judy K Mattson | |||||||
| Pharmacist | 40.00 | 109892 | 0 | 33408 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 820626 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 182723 | 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 |
|---|---|---|---|---|---|
| Olaf Anderson & Son Construction Inc | |||||
| PO Box 2766 | Fargo | ND | 58108 | Construction | 2660639 |
| Wapiti Medical Group | |||||
| PO Box 92 | Newell | SD | 57760 | Locum Physicians | 1088549 |
| Grand Forks Heating AC and Sheet Metal | |||||
| 2800 Gateway Dr | Grand Forks | ND | 58203 | Construction | 1077369 |
| CMDI | |||||
| 150 10th St NW | Milaca | MN | 56353 | Radiology Services | 598250 |
| Falls Electric | |||||
| 720 Dawn Ave | Thief River Falls | MN | 56701 | Construction | 500476 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| Government Grants | 38908 | GovernmentGrants |
| All Other Contributions | 412101 | AllOtherContributions |
| Total Contributions | 451009 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Net Patient Service re | 622110 | 34327953 | 34327953 | |
| Other Revenue | 621500 | 762642 | 760661 | 1981 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 35090595 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 451950 | TotalRevenueColumn |
| Exclusion | $451,950 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 281278 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 282449 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -1171 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1171 | TotalRevenueColumn |
| Exclusion | -$1,171 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4829 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -4829 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -4829 | TotalRevenueColumn |
| Exclusion | -$4,829 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35987554 | TotalRevenueColumn |
| Related Or Exempt Function Income | 35088614 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1981 | UnrelatedBusinessRevenue |
| Exclusion | $445,950 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3000 | Total |
| Program Services | 3000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 448611 | Total |
| Management And General | 448611 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14447129 | Total |
| Program Services | 12578495 | ProgramServices |
| Management And General | 1868634 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 475795 | Total |
| Program Services | 422283 | ProgramServices |
| Management And General | 53512 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3067109 | Total |
| Program Services | 2630455 | ProgramServices |
| Management And General | 436654 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1055808 | Total |
| Program Services | 895054 | ProgramServices |
| Management And General | 160754 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64151 | Total |
| Management And General | 64151 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3436707 | Total |
| Program Services | 3216223 | ProgramServices |
| Management And General | 220484 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140821 | Total |
| Management And General | 140821 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5064563 | Total |
| Program Services | 4202627 | ProgramServices |
| Management And General | 861936 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 209 | Total |
| Management And General | 209 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 523230 | Total |
| Program Services | 515236 | ProgramServices |
| Management And General | 7994 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 420958 | Total |
| Program Services | 380539 | ProgramServices |
| Management And General | 40419 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64848 | Total |
| Program Services | 26478 | ProgramServices |
| Management And General | 38370 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 318946 | Total |
| Program Services | 318946 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1497775 | Total |
| Program Services | 1497775 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133342 | Total |
| Management And General | 133342 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| Surcharge Fees | 586704 | 586704 | |
| Bad Debt Expense | 371523 | 371523 | |
| MN Care Tax | 322004 | 0 | 322004 |
| Miscellaneous | 314491 | 263554 | 50937 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32757724 | Total |
| Program Services | 27431575 | ProgramServices |
| Management And General | 5326149 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5874615 | BOY |
| EOY | 6049003 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5697094 | BOY |
| EOY | 4613215 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 429614 | BOY |
| EOY | 422852 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 158455 | BOY |
| EOY | 121217 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 39274362 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 17698979 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16435937 | BOY |
| EOY | 21575383 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18768594 | BOY |
| EOY | 16357120 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 580723 | BOY |
| EOY | 605941 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160409 | BOY |
| EOY | 224931 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 283837 | BOY |
| EOY | 635809 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48389278 | BOY |
| EOY | 50605471 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4779016 | BOY |
| EOY | 4616864 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7693634 | BOY |
| EOY | 7187725 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11362 | BOY |
| EOY | 9381 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 343595 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12827607 | BOY |
| EOY | 11813970 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35561671 | BOY |
| EOY | 38791501 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35561671 | BOY |
| EOY | 38791501 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48389278 | BOY |
| EOY | 50605471 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31240 | OtherCostOrOtherBasis |
| Book Value | 31240 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20140851 | OtherCostOrOtherBasis |
| Depreciation | 10396321 | Depreciation |
| Book Value | 9744530 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9534479 | OtherCostOrOtherBasis |
| Depreciation | 6881204 | Depreciation |
| Book Value | 2653275 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9567792 | OtherCostOrOtherBasis |
| Depreciation | 421454 | Depreciation |
| Book Value | 9146338 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 21575383 | TotalOfBookValueLandBuildings |
| Total Revenue | 35987554 | TotalRevenue |
| Total Expenses | 32757724 | TotalExpenses |
| Excess Or Deficit For Year | 3229830 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 3229830 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 36270003 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 36270003 | RevenueSubtotal |
| Other Revenues Not Included | -282449 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -282449 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 35987554 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 33040173 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 282449 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 282449 | ExpensesNotRptdF990 |
| Expenses Subtotal | 32757724 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 32757724 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part IV, Line 2b: | The Medical Center acts as custodian for the funds of the residents. These funds are included with cash and cash equivalents and accounts payable - trade in these financial statements. Funds for residents and others totaled $9,381 at September 30,2010. | |
| Part X: | The Medical Center undergoes an annual analysis of its various tax positions, assessing the likelihood of those positions being upheld upon examination with relevant tax authorities. No amounts were recorded as a result of this analysis during the years ended September 30, 2010 and 2009. If the Medical Center is subject to interest or penalties related on underpaid income taxes, they will be recorded as income tax expense. Under normal circumstances, the Corporation is no longer subject to Federal and state tax examinations by tax authorities for years before 2007. | Description of Uncertain Tax Positions Under FIN 48: |
| Part XII, Line 4b - Other Adjustments: | Rental Expense Recorded in Expense for Financial Statements: -282449. | |
| Part XIII, Line 2d - Other Adjustments: | Rental Expense Recorded in Expense for Financial Statements: 282449. |
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 |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| 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 | 221387 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 221387 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00680 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4527681 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4563918 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -36237 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4749068 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4563918 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 185150 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00680 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 165931 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 565 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 165366 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00510 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 53930 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 53930 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10470193 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7347973 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3122220 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09640 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8770 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8770 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10698824 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7348538 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3350286 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10320 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15447892 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11912456 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3535436 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 19612 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 19612 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4288 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4288 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 125535 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 125535 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 149435 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 149435 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00460 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $191,758 | BadDebtExpenseAmount |
| Amount Attributable To | 2080 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5252171 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5200169 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 52002 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | Er OtherErOther | OtherOther |
|---|---|---|---|---|---|---|---|---|---|
| LifeCare Medical Center | |||||||||
| 715 Delmore Drive | Roseau | MN | 56751 | X | X | X | X | X | Urgent Care |
| LifeCare Roseau Manor | |||||||||
| 715 Delmore Drive | Roseau | MN | 56751 | Skilled Nursing Facility | |||||
| LifeCare Greenbush Manor | |||||||||
| 19120 290th Street | Greenbush | MN | 56726 | Skilled Nursing Facility | |||||
| LifeCare Home Care and Hospice | |||||||||
| 715 Delmore Drive | Roseau | MN | 56751 | Home Health and Hospice | |||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: The organization does not provide discounted care. | IncomeBasedCriteria |
| Annual Community Benefit Expln | Part I, Line 6a: | AnnualCommunityBenefitExpln |
| Costing Method Used | Part I, Line 7: Charity care was converted to cost using the cost-to-charge ratio derived from Worksheet 2. Medicaid was converted to cost using the cost-to-charge ratio derived from Worksheet 2. Community health improvements and cash and in-kind contributions are calculated at actual costs recorded in the general ledger. Education costs are based on estimated time and wages to manage students and interns at the facilities. Subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare Cost Report. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: Costs related to a physician's clinic is $184,674. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: The amount of bad debt expense removed from total expenses to determine the percentage was $371,523. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Bad debt was converted to cost using the cost-to charge ratio derived from Worksheet 2.The estimated amount of bad debt expense attributable to patients eligible under the organization's charity care policy is calculated by using gross charity care at charge as a percentage of total gross hospital revenue. It is reasonable to assume that charity care as a percentage of gross revenue can also be applied to bad debt.Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Financial Statement Note:The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients, residents, and third-party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Medicare allowable costs of care are based on Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by CMS. | ShortfallAsCommunityBenefit |
| Number Of Facility Type Expln | Part V: | NumberOfFacilityTypeExpln |
| General Explanation | Part I, Line 6b: The organization's community benefit report can be found on its website at lifecaremedicalcenter.org and is shared with service area residents in an annual newsletter that focuses on community benefit. | GeneralExplanation |
| Needs Assessment | Part VI, Line 2: LifeCare provides the Public Health functions for the Roseau County. Through this role, we participate in a community needs assessment through Quinn County to assess the needs of our service area. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: We have financial counselors who have phone conversations with patients during our collections process. We guide patients to other financial programs as well as our own charity care program. Brochures are available in the admitting area which is in the same location as the Emergency Room. Information is also sent to our patients via patient bills. Our website does have a brief description of our charity care program and a phone number to reach a financial counselor. Our new website will also have the charity care application and brochure. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Roseau County is a rural area with a population of approximately 17,000 people. We are the sole hospital located in Roseau County and the nearest tertiary hospital is two hours away. We are a federally-designated medically underserved area. In 2009, approximately 12.7% of the population was age 65 or older. The average per capita income is 23,061 and approximately 9.7% of the population is below the federal poverty level. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: Community support includes donations to local community organizations and employee staff time donated to local community committees. Environmental improvements include employee time called the Green Team. Employees of the Green Team managed the process for creating other recycling opportunities for its employees that would not otherwise be available to the them. The Hospital also had a couple of employees who met with the City of Greenbush to discuss water treatment and improvements of the city. By being involved in the community through the above activities, we are able to increase health awareness.Roseau County is considered a Health Professional Shortage Area and therefore is including the costs of recruitment in workforce development. This promotes better care for our patients. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: The organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay. | OtherInformation |
| Reports Filed With States | MN | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| 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 | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cathy Huss | |||||||||||||
| 142414 | 0 | 0 | 0 | 0 | 0 | 9098 | 0 | 20832 | 0 | 172344 | 0 | 0 | 0 |
| Keith Okeson | |||||||||||||
| 186430 | 0 | 0 | 0 | 0 | 0 | 11980 | 0 | 27857 | 0 | 226267 | 0 | 0 | 0 |
| Gordon Streiff | |||||||||||||
| 121291 | 0 | 0 | 0 | 0 | 0 | 8011 | 0 | 26572 | 0 | 155874 | 0 | 0 | 0 |
| Sue Lisell | |||||||||||||
| 142747 | 0 | 0 | 0 | 0 | 0 | 8725 | 0 | 8404 | 0 | 159876 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 1 | The organization has an Executive Committee which has the authority to act on behalf of the Board of Trustees between regularly scheduled board meetings. The Executive Committee consists of the board's officers (Chair, Vice Chair, Secretary and Treasurer) as well as one member-at-large from the Board of Trustees. |
| Form 990, Part VI, Section B, line 11 | The return is made available to the Board of Trustees before it is filed. The return is reviewed initially by the CFO. |
| Form 990, Part VI, Section B, line 12c | All officers, trustees, and key employees are required to complete a conflict of interest form annually. The form is reviewed by the Board of Trustees to determine if any conflicts exist. If there are any conflicts, the Board of Trustees will discuss the restrictions that should be placed on the person with the conflict. Restrictions are typically related to voting and discussion of matters related to the conflict. |
| Form 990, Part VI, Section B, line 15 | The compensation for the CEO and CFO is approved by the Executive Committee based on comparability data. The CEO and CFO both have employment contracts. The deliberation and discussion of compensation is documented in the board meeting minutes. This process takes place on an annual basis. |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy, and financial statements are available upon request. |