2011-05-16T10:31:39-07:00 2010-09-30 990 2009-10-01 410730602 LAKE REGION HEALTHCARE CORPORATION LAKE 2187368000 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 EDWARD STRAND CPA INACTIVE 2187368000 2011-05-13 2009 2016-02-24 21:20:13Z LARRY SCHULZ 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 56537 91801246 0 X www.lrhc.org X 1951 MN THE PURPOSE OF LAKE REGION HEALTHCARE IS TO PROVIDE QUALITY HEALTHCARE SERVICE IN A CARING MANNER TO EACH INDIVIDUAL WE SERVE. 15 9 650 210 0 0 129019 233138 57946018 76477915 1157995 -208947 749048 2069355 59982080 78571461 0 0 0 0 30692410 34971557 0 0 0 25739914 42286522 56432324 77258079 3549756 1313382 89792552 116839958 23586368 46294383 66206184 70545575 THE PURPOSE OF LAKE REGION HEALTHCARE IS TO PROVIDE QUALITY HEALTHCARE SERVICE IN A CARING MANNER TO EACH INDIVIDUAL WE SERVE. 0 0 66389768 232388 74071281 LAKE REGION HEALTHCARE CORPORATION IS A NOT-FOR-PROFIT PROVIDER OF HEALTH CARE SERVICES OPERATING A 108 BED HOSPITAL COMPRISED OF AN 80 BED ACUTE HOSPITAL, A 14 BED PSYCHIATRIC UNIT, A 14 BED INPATIENT REHABILITATION UNIT, AND MULTIPLE CLINIC SITES. OUR PURPOSE IS TO MEET THE HEALTHCARE NEEDS OF THE PEOPLE OF WEST CENTRAL MINNESOTA. OUR VISION IS TO BE MINNESOTA'S PREEMINENT REGIONAL HEALTHCARE PARTNER. OUR CORE VALUES INCLUDE INTEGRITY, TEAMWORK, COMPASSION AND EXCELLENCE. LAKE REGION HEALTHCARE CORPORATION IS A PROVIDER OF QUALITY HEALTHCARE SERVICES, AS NOTED BY OUR ACCREDITATION BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS, MINNESOTA HOSPITAL ASSOCIATION, CARF, CARDIAC REHABILITATION NATIONAL CERTIFICATION, AND CAP LABORATORY ACCREDITATION PROGRAM. WE WERE ALSO NAMED ONE OF THE COUNTRY'S TOP 100 HOSPITALS IN PERFORMANCE IMPROVEMENT BY THOMSON REUTERS. MANY OF THE SERVICES THAT LAKE REIGON HEALTHCARE PROVIDES INCLUDE SPORTS MEDICINE, BIRTHING SUITES, CARDIAC REHAB/ECP, EMERGENCY SERVICES, CLINIC SERVICES, LABORATORY, NURSING MEDICAL/SURGICAL, PEDS, OB GYN, ICCU, RADIOLOGY/INTERVENTIONAL RADIOLOGY, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH THERAPY, RESPIRATORY CARE, SOCIAL WORK, SURGERY, AND A CANCER TREATMENT IN OUR CANCER CENTER. LAKE REGION HEALTHCARE ALSO PROVIDES MANY PROGRAMS AND SERVICES THAT ARE AVAILABLE TO THE COMMUNITY TO PROMOTE A HEALTHCY LIFESTYLE. 1771586 750 3039232 BRIDGEWAY CARE AT LRH PROVIDES UNCOMPLICATED ACCESS TO COMPREHENSIVE MENTAL HEALTH SERVICES. THE 14-BED FACILITY ALLOWS PATIENTS AND FAMILY TO SPEND TIME IN A POSITIVE ENVIRONMENT WHERE THE STAFF FOCUSES ON PATIENTS' INDIVIDUAL NEEDS. PATIENTS HAVE PRIVATE ROOMS; HOWEVER THEY ARE STILL ABLE TO INTERACT THROUGH A SHARED KITCHEN, LIVING ROOM, AND COMMUNITY ROOM. STAYS AT BRIDGEWAY CAN RANGE FROM ONE NIGHT TO A FEW WEEKS. IT PROVIDES SPECIALIZED CARE FOR ADOLESCENTS, ADULTS, AND SENIOR CITIZENS. OUR EXPERIENCED STAFF WORKS AS A TEAM WITH A GOAL TO IMPROVE THE HEALTH AND QUALITY OF LIFE, EMPHASIZE ABILITIES RATHER THAN DISABILITIES, AND PROMOTE INDEPENDENCE. 1402272 0 1441651 THE CENTER FOR REHABILITATION IS AN INPATIENT REHABILITATION UNIT THAT SERVES PATIENTS THAT REQUIRE A HIGH LEVEL OF MEDICAL ATTENTION AND REHABILITATION SERVICES. IT IS A 14-BED CENTER, WHICH PROVIDES EACH PATIENT A PRIVATE ROOM. THE CENTER FOR REHABILIATION IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES. PATIENTS ARE PROVIDED A SPACIOUS GYM AREA, COMMUNITY LIVING TRAINING SPACE, AS WELL AS AN APARTMENT ATMOSPHERE TO PREPARE THE PATIENT FOR THEIR RETURN TO THE COMMUNITY. 0 0 0 69563626 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 1 0 1 28 0 0 650 1 0 0 0 0 0 15 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X X LAKE REGION HEALTHCARE CORPORATION 2187368000 712 S CASCADE ST FERGUS FALLS MN 565380728 Stephen Rufer 5.0 X 0 0 0 Solveig Halbakken 5.00 X 0 0 0 David Johnson 5.00 X 0 0 0 Dennis Emmem 5.00 X 0 0 0 William Colbeck 5.00 X 0 0 0 Gary Spies 5.00 X 0 0 0 Mary Lampy Velo 5.00 X 0 0 0 James Matter MD 5.00 X 0 0 0 Jim Worner 5.00 X 0 0 0 DT Bjork MD 5.00 X 0 0 0 Larry Dorn 5.00 X 0 0 0 John Erickson 5.00 X 0 0 0 Deb Ferguson 5.00 X 0 0 0 Laurel Nelson 5.00 X 0 0 0 J E Andrews MD 5.00 X 0 0 0 Larry Schulz 40 X 323691 0 19260 Edward Strand 40.00 X 267124 0 146800 Patrick Glynn 40.00 X 242783 0 23426 Jeffery Wachlarowicz 40.00 X 196467 0 22529 Thomas Debrito 40.00 X 197633 0 19222 Joy Lindgren 40.00 X 192058 0 22094 David Winans 40.00 X 190266 0 21652 1610022 0 274983 15 0 1 0 LAKE REGION MEDICAL GROUP PA 615 S MILL ST FERGUS FALLS MN 56537 PHYSICIAN SERVICES 5933155 FERGUS FALLS MEDICAL GROUP PA 615 S MILL ST FERGUS FALLS MN 56537 PHYSICIAN SERVICES 3045690 PATRIOT MEDICAL TECHNOLOGIES PO Box 415000 NASHVILLE TN 372415000 EQUIPMENT MAINTENANCE 503173 CONNECT HEALTH INC 603 S DAKOTA ST MILBANK SD 57252 PHYSICIAN SERVICES 403880 COMPHEALTH PO BOX 972651 DALLAS TX 753972651 PHYSICIAN SERVICES 334396 9 0 0 0 0 0 233138 0 233138 PATIENT CARE SERVICES 622000 75674860 75674860 0 0 MEDICAL BUILDING LEASE 531120 404624 404624 0 0 MEDICAL EQUIPMENT LEASE 900002 398431 398431 0 0 0 0 0 0 76477915 709600 709600 0 0 0 0 0 0 0 0 0 0 150681 0 334320 0 -183639 0 -183639 -183639 0 0 11236008 740910 12254872 640593 -1018864 100317 -918547 -918547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OUTSIDE SERVICE REVENUE 622000 1119541 1119541 0 0 MISCELLANEOUS 622000 623268 623268 0 0 CAFETERIA REVENUE 622000 341041 341041 0 0 169144 169144 0 0 2252994 78571461 78338323 0 0 0 0 0 0 0 0 0 0 590815 0 590815 0 0 0 0 0 28324878 24854747 3470131 0 1217046 1046123 170923 0 2783496 2392579 390917 0 2055322 1766671 288651 0 0 0 0 0 571787 0 571787 0 192808 0 192808 0 0 0 0 0 0 0 0 0 0 0 14735394 14735394 0 0 396393 340723 55670 0 320140 0 320140 0 0 0 0 0 0 0 0 0 821430 719458 101972 0 76369 42835 33534 0 0 0 0 0 0 0 0 0 943797 879806 63991 0 0 0 0 0 4223596 2780482 1443114 0 295408 295408 0 0 SUPPLIES 9822637 9822637 0 0 BAD DEBTS 3217598 3217598 0 0 MISCELLANEOUS 2991474 2991474 0 0 REPAIRS AND MAINTENANCE 2480442 2480442 0 0 MN HEALTH TAX & SURCHARGE 1197249 1197249 0 0 77258079 69563626 7694453 0 7743255 4643680 0 0 0 0 10596671 33526362 0 0 0 0 0 0 1083584 2112524 173599 506885 93169207 42852189 37184861 50317018 26789702 18666932 0 0 0 0 6220880 7066557 89792552 116839958 11982191 13815267 0 0 0 0 4775000 15635000 0 0 0 0 5357185 15063702 0 0 1471992 1780414 23586368 46294383 X 0 0 0 0 66206184 70545575 66206184 70545575 89792552 116839958 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 2562937 2562937 0 58698347 23930653 34767694 0 1793521 915860 877661 0 29400205 17960360 11439845 0 714197 45316 668881 50317018 ASSETS LIMITED AS TO USE 2176714 FUNDS HELD BY TRUSTEE 2369075 PROPERTY HELD FOR INVESTMENT 1171158 INVESTMENT IN OTHER ENTITIES 386495 DEFERRED FINANCING COSTS 673116 OTHER NONCURRENT RECEIVABLES 289999 7066557 0 EMPLOYEE DEFERRED COMPENSATION 1780414 1780414 78571461 77258079 1313382 2424394 0 0 0 -786514 1637880 2951262 78986388 0 0 0 0 0 78986388 0 -414927 -414927 78571461 77258079 0 0 0 0 0 77258079 0 0 0 77258079 SchD_P10_S00_L00 Schedule D, Part X LAKE REGION HEALTHCARE UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THESE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES. LAKE REGION HEALTHCARE BELIEVES THAT IT IS COMPLIANT WITH ALL TAX REGULATIONS AND, AS OF SEPTEMBER 30, 2010, NO AMOUNTS WERE RECORDED AS A RESULT OF THIS ANALYSIS. IF LAKE REGION HEALTHCARE IS SUBJECT TO INTEREST OR PENALTIES ON UNDERPAID INCOME TAXES, THEY WILL BE RECORDED AS INCOME TAX EXPENSE. LAKE REGION HEALTHCARE BELIEVES IT IS NO LONGER SUBJECT TO FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2007. LRH MEDICAL PROPERTIES IS A MINNESOTA LIMITED LIABILITY COMPANY SOLELY OWNED BY LRHC AND RECOGNIZED BY THE INTERNAL REVENUE SERVICE FOR US FEDERAL INCOME TAX PURPOSES AS A PASS-THROUGH ENTITY, IS TREATED AS A DISREGARDED ENTITY FOR TAX PURPOSES, AND WILL BE INCLUDED IN SCHEDULE R OF LRHC'S IRS FORM 990. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 There was a total of $-786,514.00 of Related Company Transfers by Lake Region Healthcare for fiscal year ending 09/30/10. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b $-434,224 consists of Investment Income (Loss) of ($331,603) and Other Income (Expense) of ($83,323). 1 1 1 X 1.75 1 X 1.75 1 1 1 0 1 1 0 0 204264 0 204264 0.0028 0 0 11237426 0 11237426 0.1518 0 0 0 0 0 0 0 0 11441690 0 11441690 0.1546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0000 0 0 11441690 0 11441690 0.1546 0 0 0 0 0 0 0 0 10000 0 10000 0.0001 0 0 22000 22000 0.0003 0 0 0 0 0 0 0 0 5000 0 5000 0 0 0 0 0 0 0 0 0 5000 0 5000 0 0 0 5000 0 5000 0 0 0 0 0 0 0 0 0 47000 0 47000 0.0004 1 1673151 836576 16450000 18725000 -2275000 X 1 1 LRH RAD ONC SERVICES RADIATION ONCOLOGY 0.5 0 0.5 WEST CENTRAL LINEN SERVICE LAUNDRY/LINEN 0.5 0 0 LAKE REGION HEALTHCARE CORPORATION

712 S CASCADE ST FERGUS FALLS MN 56537

X X X THE COST METHODOLOGY USED IN DETERMINING THE AMOUNTS IS AN ADJUSTED MEDICARE COST OF CHARGE RATIO. BAD DEBT EXPENSE EXCLUDED FROM CALCULATING PERCENT OF TOTAL EXPENSES: $3,217,598 BAD DEBTS EXPENSE IS THE UNCOLLECTED AMOUNTS OF CHARGES BY INDIVIDUALS UNWILLING TO PAY. IT IS ESTIMATED THAT HALF OF THE BAD DEBTS WOULD HAVE BEEN CLASSIFIED AS CHARITY CARE. HOWEVER RECEIVING NO RESPONSE FROM THE INDIVIDUALS AFTER MULTIPLE ATTEMTS, THE NONPAYMENT IS CLASSIFIED AS A BAD DEBT. THE COST METHODOLOGY USED IN DETERMINING THE AMOUNTS IS AN ADJUSTED MEDICARE COST OF CHARGE RATIO. HOWEVER PATIENTS WERE UNWILLING TO APPLY FOR CHARITY CARE, AND SO THE CLAIM WAS CLASSIFIED AS BAD DEBTS. ALL SHORTFALL DUE TO THE COST EXCEEDING THE REVENUE RECEIVED FROM MEDICARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE RELATED COSTS IS AN ADJUSTED MEDICARE COST TO CHARGE RATIO. THE COLLECTION POLICY STATES THAT CERTAIN INDIVIDUALS WITH VERY LIMITED MEANS MAY NOT BE ABLE TO MEET THE ACCEPTABLE PAYMENT GUIDELINES. WHEN THIS OCCURS, THE COLLECTION STAFF WILL EXHAUST EVERY CONSIDERATION TO RESOLVE THE ACCOUNT SUCH AS APPLICATIONS FOR MEDICAL AND GENERAL ASSISTANCE AND THE HOSPITAL CHARITY CARE PROGRAM. A REDUCED PAYMENT PLAN MAY BE CONSIDERED IF THE PATIENT'S DESIRE TO PAY THEIR OBLIGATION AND PERSONAL PRIDE INDICATES THAT SPECIAL CONSIDERATION SHOULD BE GIVEN. APPLICATIONS FOR CHARITY CARE ARE PROVIDED UPON REQUEST OR WHEN A PATIENT DEMONSTRATES THE NEED FOR THE CHARITY CARE PROGRAM ASSISTANCE. ONE OF LAKE REGION HEALTHCARE'S GUIDING PRINCIPALS IS TO PROVIDE A HEALTHCARE SYSTEM THAT IS RESPECTFUL AND RESPONSIVE TO THEIR CUSTOMERS' NEEDS. IT IS BEING ASSESSED ON A CONTINUAL BASIS. PERIODICALLY LAKE REGION HEALTHCARE WORKS WITH THE OTTER TAIL COUNTY DEPARTEMNT OF HEALTH TO PERFORM A FORMAL NEEDS ASSESSMENT OF THE COMMUNITY IT SERVES. FOR THE UNINSURED OR SELF PAY DISCOUNT, OUTPATIENT OR CLINIC SERVICES PATIENTS ARE SENT A LETTER AFTER ESTABLISHING THEIR FINANCIAL STATUS AS SELF PAY. THE LETTER INFORMS THEM THAT THERE IS A DISCOUNT PROGRAM THAT MAY BE AVAILABLE TO THEM IF THEY ARE WITHOUT INSURANCE. LAKE REGION HEALTHCARE FOLLOWS UP WITH A PHONE CALL TO SEE IF THEY RECEIVED THE LETTER TO DISCUSS THE PATIENTS' OPTIONS. ONCE IN THE COLLECTION PROCESS, PATIENTS WILL BE ASSESSED AS TO WHETHER OR NOT THEY WOULD BE ELIGIBLE FOR THE SELF PAY DISCOUNT. INPATIENTS ARE VISITED BY A PATIENT FINANCIAL SERVICES STAFF MEMBER TO EXPLAIN THE UNINSURED/SELF PAY DISCOUNT AND IF ELLIGIBLE, GIVEN AN APPLICATION. FOR THE COMMUNITY CARE PROGRAM, OUTPATIENT OR CLINIC SERVICES PATIENTS DISCUSS OVER A PHONE CALL INITIATED EITHER BY THE PATIENT FINANCIAL SERVICES STAFF, OR THE PATIENT. IF ELIGIBLE FOR COMMUNITY CARE, THE PATIENT IS SENT AN APPLICATION. INPATIENTS ARE INFORMED WHEN THE PATIENT FINANCIAL SERVICES STAFF MEMBER VISITS THE PATIENT DURING THE HOSPITAL STAY. IF ELIGIBLE FOR COMMUNITY CARE, THEY ARE GIVEN AN APPLICATION AT THAT TIME. FINANCIAL SERVICES PAMPLETS THAT EXPLAIN BOTH PROGRAMS ARE DISPERCED AROUND THE FACILITY. PROGRAM INFORMATION CAN ALSO BE ACCESSED ON LAKE REGION HEATLHCARE'S WEBSITE. EMPLOYEES AMONGST THE PATIENT DEPARTMENTS WORK WITH THE BUSINESS OFFICE TO BE SURE THAT EVERYONE WHO MAY BE ELIGIBLE, RECEIVES THE APPROPRIATE INFORMATION. THE COLLECTION AGENCIES THAT ARE CONTRACTED WITH LAKE REGION HEALTHCARE ARE ALSO AWARE, AND OFFER EITHER PROGRAM IF APPROPRIATE. LAKE REGION HEALTHCARE PROVIDES PRIMARY AND SECONDARY HEALTHCARE SERVICES IN A RURAL AREA OF WEST CENTRAL MINNESOTA WITH A POPULATION OF APPROXIMATELY 100,000 PEOPLE. THE AVERAGE AGE OF THE POPULATION IS OLDER THAN BOTH THE STATE AND NATIONAL AVERAGES WHICH LEADS TO A HIGHER THAN NORMAL PERCENTAGE OF OLDER PATIENTS WHOM THE HOSPITAL SERVES. APPROXIMATELY TWO-THIRDS OF THE PATIENT DAYS AT LAKE REGION HEALTHCARE ARE USED BY MEDICARE-AGED PATIENTS. THE MOST TANGIBLE WAY THAT LAKE REGION HEALTHCARE PROVIDES COMMUNITY BENEFITS IS THROUGH COMMUNITY PROGRAMS AND SERVICES. IT PROVIDES THESE SERVICES AS A RESPONSIBLE MEMBER OF THE COMMUNITY. EDUCATIONAL PROGRAMS, HEALTHCARE SCREENINGS, SUPPORTS GROUPS, AND OTHER COMMUNITY SERVICES ARE PROVIDED BY LAKE REGION HEALTHCARE TO IMPROVE THE HEALTHCARE AND QUALITY OF LIFE FOR THE PEOPLE IN THE COMMUNITY. MEETING THE HEATLHCARE NEEDS OF THE INDIVIDUALS SERVED IN WEST CENTRAL MINNESOTA IS LAKE REGION HEALTHCARE'S PURPOSE. THE MAJORITY OF THE 15 VOTING MEMBERS OF THE BOARD IS COMPRISED OF PERSONS WHO RESIDE WITHIN THIS SERVICE AREA. THE BOARD CONSISTS OF HOMEMAKERS, FARMERS, AND BUSINESS OWNERS. LAKE REGION HEALTHCARE ALSO HAS AN OPEN MEDICAL STAFF AVAILABLE FOR ALL QUALIFIED PHYSICIANS. LAKE REGION HEATLHCARE BUDGETS FOR PROGRAMS WHICH ENCOURAGE INDIVIDUALS TO PRACTICE HEALTHY LIFESTYLES, AS WELL PROVIDE SUPPORT PROGRAMS WHICH BENEFIT THE ECONOMIES AND COMMUNITES OF THEIR SERVICE AREA. MN X X X X X 0 0 0 0 0 0 0 0 0 Larry Schulz 261191 0 62500 0 0 0 0 0 19260 0 342951 0 0 0 Edward Strand 216049 0 51075 0 0 0 119000 0 27800 0 413924 0 0 0 Patrick Glynn 242783 0 0 0 0 0 0 0 23426 0 266209 0 0 0 Jeffery Wachlarowicz 196467 0 0 0 0 0 0 0 22529 0 218996 0 0 0 Thomas Debrito 197633 0 0 0 0 0 0 0 19222 0 216855 0 0 0 Joy Lindgren 192058 0 0 0 0 0 0 0 22094 0 214152 0 0 0 David Winans 190266 0 0 0 0 0 0 0 21652 0 211918 0 0 0 SchJ_P02_S00_L00 Schedule J, Part II THE CORPORATION'S EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX-DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX-DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME FUTURE DATE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNLESS CERTAIN FUTURE EVENTS OCCUR. THE AMOUNTS CONTRIBUTED TO THESE PLANS WAS $119,000 FOR THE CFO. THE TAX-DEFERRED AMOUNTS ARE POTENTIALLY REPORTED TWICE IN THE FORM 990; ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF IT IS PAID TO THE EXECUTIVE. CITY OF FERGUS FALLS MNINNESOTA 416005153 314787CY6 2010-09-02 11360000 ACQUIRE REAL & PERSONAL PROPERTY & IMPROVEMENT 0 0 11360000 820585 0 0 227195 545220 9767000 2040 0 0 1 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 LAKE REGION MEDICAL GROUP PHYSICIANS IN MEDICAL GROUP ARE BOARD MEMBERS 5933155 PHYSICIAN SERVICES 0 FERGUS FALLS MEDICAL GROUP PHYSICIANS IN MEDICAL GROUP ARE BOARD MEMBERS 3045690 PHYSICIAN SERVICES 0 OTTER TAIL CORPORATION OTPCO'S BOARD MEMBER & CEO ARE BOARD MEMBERS 527063 ELECTRICAL UTILITY SERVICES/ELECTRICAL SERVICES 0 PEMBERTON SORLIE RUFER KERSHNER PLLP SENIOR PARTNER IS A BOARD MEMBER 246027 ATTORNEY SERVICES 0 F990_P06_S0B_L11 Form 990, Part VI, Section B, Line 11 LAKE REGION HEALTHCARE CORPORATION'S BOARD OF DIRECTORS FINANCE COMMITTEE DESIGNATES A SUB-COMMITTEE TO REVIEW AND APPROVE THE FORM 990 TO BE FILED. IT IS THEN PRESENTED FOR APPROVAL BY THE BOARD OF DIRECTORS. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c OFFICERS AND TRUSTEES ANNUALLY ASSESS WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST ACCORDING TO THE CONFLICTS OF INTEREST POLICY. IT IS CONSISTANTLY MONITORED DURING THE YEAR TO BE SURE THAT THE WRITTEN POLICY IS BEING FOLLOWED. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 COMPENSATION FOR THE OFFICERS OF LAKE REGION HEALTHCARE IS REVIEWED ANNUALLY AND COMPARED TO SALARY SURVEYS FOR SIMILAR ORGANIZATIONS. COMPENSATION IS PRESENTED FOR APPROVAL TO THE EXECUTIVE COMMITTEE. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 LAKE REGION HEALTHCARE'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY REQUEST. F990_P07_S0A_L01a Form 990, Part VII, Section A, Line 1a THE ESTIMATED AMOUNT OF OTHER COMPENSATION FROM THE ORGANIZATION AND RELATED ORGANIZATIONS (COLUMN F) CONSISTS OF THE EMPLOYER CONTRIBUTIONS TOWARD NONTAXABLE BENEFITS, NONTAXABLE PENSION CONTRIBUTIONS, AND TAX-DEFERRED COMPENSATION. SEE SCHEDULE J, PART III, SUPPLEMENTAL INFORMATION REGARDING THE TAX-DEFERRED COMPENSATION. LRH MEDICAL PROPERTIES 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 271293671 PROVIDE REAL AND PERSONAL PROPERTY FOR HEALTHCARE SERVICES MN -125481 12440279 LAKE REGION HEALTHCARE CORPORATION LAKE REGION HOSPITAL FOUNDATION 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 411677288 FOUNDATION MN 501(C)(3) SO TYPE 1 LAKE REGION HEALTHCARE CORPORATION LRHC LONG TERM CARE FACILITIES INC 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 411817549 ASSISTED LIVING MN 501(C)(3) PSO N/A WEST CENTRAL LINEN SERVICE 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 411411129 LAUNDRY/LINEN MN N/A Unrelated 0 226463 0 0 0 LRH RAD ONC SERVICES 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 271322270 RADIATION ONCOLOGY SERVICES MN LAKE REGION HEALTHCARE CORPORATION LAKE REGION MEDICAL GROUP Related 0 160032 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 LRH RAD ONC SERVICES i 625770 LAKE REGION HOSPITAL FOUNDATION n 35000