INTERNATIONAL FALLS MEMORIAL HOSPITAL ASSN: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- INTERNATIONAL FALLS MEMORIAL HOSPITAL ASSN (EIN 41-0726171)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-07
- IRS object ID
- 202343119349302654
- Schema version
- 2022v5.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-07T11:35:15-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410726171 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INTERNATIONAL FALLS MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL ASSOCIATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INTE | BusinessNameControlTxt |
| Phone | 2182834481 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 HIGHWAY 71 | AddressLine1Txt |
| City | INTERNATIONAL FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56649 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG BOYER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2182834481 | PhoneNum |
| Signature | 2023-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CRAIG | PersonFirstNm |
| Person Last | BOYER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2023-11-07 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAINY LAKE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CRAIG BOYER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 HIGHWAY 71 | AddressLine1Txt |
| City | INTERNATIONAL FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $37,642,110 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RAINYLAKEMEDICAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1945 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE ACCESSIBLE, HIGH-QUALITY HEALTHCARE TO OUR COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 240 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $1,011 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,895,311 | PYContributionsGrantsAmt |
| CY Contributions Grants | $688,959 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,310,872 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,022,783 | CYProgramServiceRevenueAmt |
| PY Investment Income | $354,380 | PYInvestmentIncomeAmt |
| CY Investment Income | $82,278 | CYInvestmentIncomeAmt |
| PY Other Revenue | $269,815 | PYOtherRevenueAmt |
| CY Other Revenue | $228,318 | CYOtherRevenueAmt |
| PY Total Revenue | $38,830,378 | PYTotalRevenueAmt |
| CY Total Revenue | $35,022,338 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $20,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,180,556 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,240,251 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,762,668 | PYOtherExpensesAmt |
| CY Other Expenses | $17,303,812 | CYOtherExpensesAmt |
| PY Total Expenses | $31,963,224 | PYTotalExpensesAmt |
| CY Total Expenses | $33,544,063 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,867,154 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,478,275 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $41,507,642 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,634,235 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,131,238 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,727,616 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,376,404 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,906,619 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE ACCESSIBLE QUALITY HEALTHCARE TO OUR COMMUNITIES USING VALUES OF INTEGRITY AND RESPECT, COMPASSION AND EXCELLENCE THROUGH TEAMWORK (ICE) IN SUPPORT OF THE VISION COMPRISED OF THE FOLLOWING ELEMENTS: PROVIDER OF CHOICE OF OUR COMMUNITIES, PATIENT AND FAMILY-CENTERED CARE, EXPANDING SERVICES, REGIONAL SPECIALTY RELATIONSHIPS AND PREFERRED HEALTHCARE EMPLOYER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $24,951,145 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $31,564,346 | RevenueAmt |
| Desc | RAINY LAKE MEDICAL CENTER (RLMC) PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES. IN 2022, RLMC HAD 1,999 INPATIENT DAYS AND HAD 5,885 EMERGENCY ROOM VISITS. IN ADDITION, RLMC PROVIDES GENERAL, ORTHOPEDIC, AND OPHTHALMOLOGY SURGERY, VARIOUS IMAGING MODALITIES, LABORATORY SERVICES, THERAPY SERVICES, AND OTHER HOSPITAL ANCILLARY SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,065,242 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,612,626 | RevenueAmt |
| Desc | RLMC PROVIDES CLINIC BASED SERVICES AT TWO LOCATIONS, INTERNATIONAL FALLS, MN AND LITTLE FORK, MN. IN ADDITION TO PRIMARY CARE VISITS, A NUMBER OF SPECIALTY SERVICES ARE OFFERED SUCH AS RHEUMATOLOGY, ORTHOPEDIC, OB/GYN, DERMATOLOGY, OPTHALMOLOGY, AND ONCOLOGY. IN TOTAL, 12,692 CLINIC VISITS OCCURRED IN 2022. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | IN ADDITION TO PROVIDING DIRECT PATIENT CARE AND IN FURTHERANCE OF ITS CHARITABLE PURPOSE, RLMC PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY INCLUDING OFFERING VARIOUS COMMUNITY BASED SERVICE PROGRAMS, CASH CONTRIBUTIONS TO NON-PROFIT AGENCIES, THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS, AND STAFF TIME TO MENTORING/JOB SHADOWING. ADDITIONALLY, A NUMBER OF HEALTH RELATED EDUCATION PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS, AND PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. RLMC ALSO ACTIVELY PROMOTES ITS COMMUNITY CARE PROGRAM, WHICH PROVIDES FREE OR REDUCED COST HEALTHCARE TO PATIENTS WHO ARE UNABLE TO PAY FULLY FOR SERVICES RECEIVED. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $27,016,387 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 83 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 240 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRAIG BOYER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2182834481 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 HIGHWAY 71 | AddressLine1Txt |
| City | INTERNATIONAL FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RICHARD PETERSON | ||||||||
| CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JON TALSNESS | ||||||||
| VICE CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEVEN LINDBERG | ||||||||
| TREASURER | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRIAN BRIGGS | ||||||||
| SECRETARY | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SUSAN CONGRAVE | ||||||||
| MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| SHERRI MANNAUSAU | ||||||||
| MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| DON BILLIG | ||||||||
| MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT PASTOR II | ||||||||
| CEO | 40.00 | Yes (X) | $305,731 | $0 | $52,437 | 1.00 | ||
| MIKE KATIGBAK | ||||||||
| CFO (THRU OCT) | 40.00 | Yes (X) | $87,112 | $0 | $6,840 | 1.00 | ||
| MELISSA MARCOTTE | ||||||||
| CFO (THRU FEB) | 40.00 | Yes (X) | $107,153 | $0 | $1,256 | 1.00 | ||
| DAVID MOYER | ||||||||
| PHYSICIAN | 40.00 | $356,798 | $0 | $20,243 | Yes (X) | |||
| DANIEL MARGO | ||||||||
| GENERAL SURGEON | 20.00 | $313,866 | $0 | $37,291 | Yes (X) | |||
| JAY KNAAK | ||||||||
| PHYSICIAN | 40.00 | $254,464 | $0 | $43,255 | Yes (X) | |||
| SCOTT JOHNSON | ||||||||
| PHYSICIAN | 40.00 | $162,036 | $0 | $23,287 | Yes (X) | |||
| AMBER BIONDICH | ||||||||
| NURSE PRACTITIONER | 40.00 | $161,707 | $0 | $5,016 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,748,867 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $189,625 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ACUTE CARE INC | |||||
| 1609 N ANKENY BLVD SUITE 200 | ANKENY | IA | 50023 | PHYSICIAN FEES | $2,092,168 |
| RC SHEFLAND ANESTHESIA LTD | |||||
| PO BOX 7 | INTERNATIONAL FALLS | MN | 56649 | ANESTHESIOLOGIST FEES | $524,762 |
| ONE NECK | |||||
| 625 JUNCTION ROAD | MADISON | WI | 53717 | IT SOLUTIONS SERVICES | $487,290 |
| KRAUS ANDERSON | |||||
| 206 BELTRAMI AVE SW | BEMIDJI | MN | 56601 | CONSTRUCTION | $451,867 |
| SANFORD HEALTH | |||||
| PO BOX 5074 | SIOUX FALLS | SD | 57117 | PROVIDING MEAL SERVICE AND SOFTWARE MAIN | $363,887 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $66,973 | RelatedOrganizationsAmt |
| Government Grants | $225,468 | GovernmentGrantsAmt |
| All Other Contributions | $396,518 | AllOtherContributionsAmt |
| Total Contributions | $688,959 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $28,714,334 | $28,714,334 |
| CLINIC REVENUE | 621110 | $2,612,626 | $2,612,626 |
| PHARMACY REVENUE | 456110 | $2,161,722 | $2,161,722 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $534,101 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $533,090 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,011 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,022,783 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $208,339 | TotalRevenueColumnAmt |
| Exclusion | $208,339 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $73,118 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $73,118 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $73,118 | TotalRevenueColumnAmt |
| Exclusion | $73,118 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,493,711 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,619,772 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$126,061 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$126,061 | TotalRevenueColumnAmt |
| Exclusion | -$126,061 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CMDI EARNINGS | Desc |
| Total Revenue Column | $155,200 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $155,200 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $155,200 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,022,338 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,176,972 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,011 | UnrelatedBusinessRevenueAmt |
| Exclusion | $155,396 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $512,914 | TotalAmt |
| Management And General | $512,914 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,939,410 | TotalAmt |
| Program Services | $10,562,045 | ProgramServicesAmt |
| Management And General | $2,377,365 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,476 | TotalAmt |
| Program Services | $194,322 | ProgramServicesAmt |
| Management And General | $46,154 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,637,616 | TotalAmt |
| Program Services | $1,250,189 | ProgramServicesAmt |
| Management And General | $387,427 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $909,835 | TotalAmt |
| Program Services | $677,937 | ProgramServicesAmt |
| Management And General | $231,898 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,566 | TotalAmt |
| Management And General | $18,566 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,254 | TotalAmt |
| Management And General | $139,254 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447 | TotalAmt |
| Management And General | $447 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,987,844 | TotalAmt |
| Program Services | $4,501,206 | ProgramServicesAmt |
| Management And General | $486,638 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,213 | TotalAmt |
| Program Services | $82,408 | ProgramServicesAmt |
| Management And General | $11,805 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,856 | TotalAmt |
| Program Services | $56,446 | ProgramServicesAmt |
| Management And General | $7,410 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,466 | TotalAmt |
| Program Services | $305,678 | ProgramServicesAmt |
| Management And General | $43,788 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $466,251 | TotalAmt |
| Program Services | $302,037 | ProgramServicesAmt |
| Management And General | $164,214 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,074 | TotalAmt |
| Program Services | $27,087 | ProgramServicesAmt |
| Management And General | $13,987 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,129 | TotalAmt |
| Program Services | $20,231 | ProgramServicesAmt |
| Management And General | $2,898 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,877 | TotalAmt |
| Program Services | $135,319 | ProgramServicesAmt |
| Management And General | $73,558 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,480,372 | TotalAmt |
| Program Services | $959,044 | ProgramServicesAmt |
| Management And General | $521,328 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,550 | TotalAmt |
| Program Services | $113,080 | ProgramServicesAmt |
| Management And General | $61,470 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $6,020,173 | $5,265,708 | $754,465 |
| EQUIPMENT RENTAL | $769,058 | $498,226 | $270,832 |
| REPAIRS & MAINTENANCE | $687,704 | $445,495 | $242,209 |
| BAD DEBT EXPENSE | $618,605 | $618,605 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,160,373 | TotalAmt |
| Program Services | $1,001,324 | ProgramServicesAmt |
| Management And General | $159,049 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,544,063 | TotalAmt |
| Program Services | $27,016,387 | ProgramServicesAmt |
| Management And General | $6,527,676 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,487,187 | BOYAmt |
| EOY | $1,275,289 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,125,476 | BOYAmt |
| EOY | $8,726,437 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,843,347 | BOYAmt |
| EOY | $4,032,713 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $644,788 | BOYAmt |
| EOY | $741,913 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $519,908 | BOYAmt |
| EOY | $542,797 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,878,522 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,936,808 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,221,141 | BOYAmt |
| EOY | $12,941,714 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,914,808 | BOYAmt |
| EOY | $5,891,672 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $677,878 | BOYAmt |
| EOY | $643,613 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,109 | BOYAmt |
| EOY | $838,087 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,507,642 | BOYAmt |
| EOY | $35,634,235 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,468,382 | BOYAmt |
| EOY | $2,705,505 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,036,907 | BOYAmt |
| EOY | $601,326 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,266,680 | BOYAmt |
| EOY | $5,852,718 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,339,269 | BOYAmt |
| EOY | $1,568,067 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,131,238 | BOYAmt |
| EOY | $10,727,616 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,223,794 | BOYAmt |
| EOY | $24,594,393 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,610 | BOYAmt |
| EOY | $312,226 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,376,404 | BOYAmt |
| EOY | $24,906,619 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,507,642 | BOYAmt |
| EOY | $35,634,235 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,478,275 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,006,108 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $58,048 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $447 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $447 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF MINNESOTA HOSPITAL ASSOCIATION AND A PERCENTAGE OF MEMBERSHIP FEE WAS RELATED LOBBYING ACTIVITIES. MINNESOTA HOSPITAL ASSOCIATION (MHA) IS AN ORGANIZATION OF 142 MEMBER HOSPITALS AND HEALTH SYSTEMS. MHA ADVOCATES ON BEHALF OF ITS MEMBERS WITH LAWMAKERS, EDUCATING THEM ON COMPLEX ISSUES IN HEALTH CARE AND ENSURING THEY HAVE THE TOOLS THEY NEED TO MAKE INFORMED DECISIONS. THE MISSION OF MHA IS TO ADVOCATE SO THEIR MEMBERS CAN ACHIEVE THEIR MISSIONS BETTER. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $168,954 | OtherCostOrOtherBasisAmt |
| Book Value | $168,954 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,587,489 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,047,589 | DepreciationAmt |
| Book Value | $10,539,900 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,786,620 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,889,219 | DepreciationAmt |
| Book Value | $1,897,401 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $335,459 | OtherCostOrOtherBasisAmt |
| Book Value | $335,459 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,941,714 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION PLAN LIABILITIES | $98,219 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | $711,550 |
| OTHER ACCRUED LIABILITIES | $18,550 |
| OPERATING LEASE LIABILITY | $739,748 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,568,067 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $86,311 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $86,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,036,790 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,175,867 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $860,923 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02610 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,123,101 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,175,867 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $947,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02870 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,900 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,900 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,981,034 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,388,779 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,592,255 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16980 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,140 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,140 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,990,074 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,388,779 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,601,295 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,113,175 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,564,646 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,548,529 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.19880 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,436 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,436 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $54,105 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $54,105 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $62,541 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $62,541 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $338,237 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $9,465,739 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,455,572 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $10,167 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAINY LAKE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 HIGHWAY 71 | AddressLine1Txt |
| City | INTERNATIONAL FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.RAINYLAKEMEDICAL.COM | WebsiteAddressTxt |
| State License | 406047 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAINY LAKE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| RAINY LAKE MEDICAL CENTER | PART V, SECTION B, LINE 5: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED EVERY 3 YEARS DURING WHICH EXTRA CARE IS TAKEN TO ENSURE THE PARTICIPATION OF LOCAL PUBLIC HEALTH AND OTHER COMMUNITY HEALTHCARE PROVIDERS, COMMUNITY HEALTH FAIRS ARE HELD WHERE COMMUNITY MEMBERS CAN PROVIDE FEEDBACK ON THEIR HEALTH CARE NEEDS. A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) HAS ALSO BEEN FORMED WHICH PROVIDES A LINK BETWEEN THE COMMUNITY AND THE ORGANIZATION. RLMC HAS A LARGE FOOTPRINT WITHIN THE COMMUNITY WITH INVOLVEMENT IN MANY SERVICE AND COMMUNITY BASED GROUPS, SPONSORING THE COMMUNITY CHRISTMAS PARADE, PLANNING ASSISTANCE WITH THE FOURTH OF JULY PARADE, SPONSORING HALLOWEEN PUMPKINPALOOSA, AND CONTRIBUTING SUPPORT TO MANY LOCAL HEALTH AND EDUCATION RELATED PROGRAMS. |
| RAINY LAKE MEDICAL CENTER | PART V, SECTION B, LINE 7D: PART V, SECTION B, LINES 7A & 10A:HTTPS://RAINYLAKEMEDICAL.COM/WP-CONTENT/UPLOADS/2023/01/2022-CHNA-WITH-IMPLEMENTATION-REPORT.PDF |
| RAINY LAKE MEDICAL CENTER | PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WERE IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA:- HEALTHCARE AFFORDABILITY/ACCESSIBILITY- MENTAL HEALTH- HEALTHCARE EDUCATION/PREVENTATIVE CARE- EMERGENCY ROOM SERVICES- DRUG/SUBSTANCE/ALCOHOL ABUSE- OBESITY/OVERWEIGHTTHE ORGANIZATION WILL NOT ADDRESS THE FOLLOWING NEEDS IDENTIFIED IN ITS MOST RECENT CHNA BECAUSE OF RESOURCE CONSTRAINTS AND THE AVAILABILITY OF OTHER RESOURCES IN THE COMMUNITY:- MENTAL HEALTH;- DRUG/SUBSTANCE/ALCOHOL ABUSE: DUE TO THE SIMILAR SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO ADDRESS THESE THREE NEEDS, WE GROUPED THESE NEEDS TOGETHER. - OBESITY/OVERWEIGHT.IN 2022 THE FACILITY TOOK THE FOLLOWING ACTIONS TO ADDRESS HEALTHCARE AFFORDABILITY/ACCESSIBILITY, HEALTHCARE EDUCATION/PREVENTATIVE CARE, AND EMERGENCY ROOM SERVICES:-13 HYPERTENSIVE PATIENTS WITH ELEVATED B/P WERE FOLLOWED IN 2022 AND LOANED A CUFF FOR ONE OR MORE TWO WEEK MONITORING PERIODS. THE RESULTS WERE MONITORED BY THE POPULATION HEALTH NURSE EVERY 2 WEEKS AND THE PCP WAS PROVIDED THE RESULTS AT THE END OF THE MONITORING PERIOD OR SOONER IF NEEDED. - 22 DIABETIC PATIENTS WERE FOLLOWED IN 2022 TO PROVIDE EDUCATION ON DIABETES MANAGEMENT, OVERSITE OF BLOOD SUGAR RESULTS, A1C GOALS, DIETARY EDUCATION, AND FOOD DIARY MONITORING. PCP RECEIVED REPORTS OF PATIENT PROGRESS VIA EMR DOCUMENTATION AND REPORTING IN PERSON AS NEEDED. - THE CONTRACTUAL CHANGES THAT WERE BROUGHT ABOUT IN 2020 AS A RESULT OF PROLONGED NEGOTIATION WITH OUR ER STAFFING COMPANY ALLOWED US TO DEVELOP A CORE GROUP OF RELIABLE ER MEDICAL PROVIDERS, RESULTING IN IMPROVED SERVICE, CARE, AND CUSTOMER SATISFACTION FROM OUR ER STAFFING COMPANY AS EVIDENCED THROUGH OUR PATIENT SATISFACTION SCORES WHICH IMPROVED ON THE QUESTION OF "WOULD YOU RECOMMEND OUR EMERGENCY ROOM TO OTHERS" FROM A MEAN SCORE OF 63 (N=212) IN 2021 TO 88.49 (N=241) IN 2022. THE STAFFING COMPANY'S CMO CONTINUED TO PERFORM MONTHLY RANDOM CHART REVIEWS TO ASSESS AND IMPROVE THE QUALITY OF THEIR PROVIDER'S DOCUMENTATION. RLMC CONTINUED TO SHARE ED PROVIDER-SPECIFIC SATISFACTION DATA AND PATIENT SURVEY COMMENTS WITH THE ED PROVIDERS TO PROMOTE SELF-IMPROVEMENT.- A WELL-ATTENDED COMMUNITY HEALTH FAIR WAS HOSTED BY OUR ORGANIZATION IN SEPTEMBER OF 2022 WITH PARTICIPATION FROM MANY CARE COMMUNITY CARE PROVIDERS. THE FAIR INCLUDED SCHEDULED "DOC TALKS" DURING WHICH OUR PHYSICIANS GAVE PRESENTATIONS ON THE IMPORTANCE OF PREVENTATIVE CARE SUCH AS COLONOSCOPIES. |
| RAINY LAKE MEDICAL CENTER | PART V, SECTION B, LINE 15E: THE CONTACT PHONE NUMBER IS LISTED ON THE WEBSITE AND PROVIDED IN ALL STATEMENTS AND LETTERS MAILED, AND A BUSINESS CARD IS INCLUDED IN THE APPLICATION PACKET. |
| RAINY LAKE MEDICAL CENTER | PART V, SECTION B, LINE 16J: WORK CLOSELY WITH COUNTY SERVICES AND COMMUNITY SENIOR ADVOCATE. |
| PART V, SECTION B, LINE 16A | HTTPS://RAINYLAKEMEDICAL.COM/WP-CONTENT/UPLOADS/2022/10/FINANCIAL-ASSISTANCE-POLICY-CHARITY-CARE.PDF |
| PART V, SECTION B, LINE 16B | HTTPS://RAINYLAKEMEDICAL.COM/WP-CONTENT/UPLOADS/2022/11/FILLABLE-NEW-RLMC-COMMUNITY-CARE-APPLICATION-EFFECTIVE-11-30-2021.PDF |
| PART V, SECTION B, LINE 16C | HTTPS://VIEW.OFFICEAPPS.LIVE.COM/OP/VIEW.ASPX?SRC=HTTPS%3A%2F%2FRAINYLAKEMEDICAL.COM%2FWP-CONTENT%2FUPLOADS%2F2022%2F11%2FPLAIN-LANGUAGE-SUMMARY-COMMUNITY-CARE-UPDATED-11-07-2022-002-1.DOCX&WDORIGIN=BROWSELINK |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE ORGANIZATION USES THE COST TO CHARGE RATIO RECOMMENDED BY WORKSHEET 2 OF THE IRS FORM 990, SCHEDULE H INSTRUCTIONS. |
| PART I, LINE 7G: | AMOUNTS USED FOR SUBSIDIZED SERVICES WERE CALCULATED USING DETAILED REPORT DATA KEPT BY THE ORGANIZATION. DATA INCLUDED THE TOTAL CHARGES, LESS ALLOWANCES AND DISCOUNTS, MEDICAID; AND ACTUAL COST OF SERVICES PROVIDED. SUBSIDIZED SERVICES INCLUDED ADULTS AND PEDIATRICS IN PATIENT, SPECIALTY CLINIC, ANESTHESIA, OPERATING ROOM AND CHEMOTHERAPY UNIT IN 2022. |
| 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 $ 618,605. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | RLMC INVESTS RESOURCES TOWARDS EMERGENCY PREPAREDNESS, PARTICULARLY A "DECONTAMINATION TEAM" THAT CONDUCTS DRILLS THROUGHOUT THE YEAR. THE TEAM IS SKILLED IN SETTING UP A PORTABLE DECONTAMINATION TENT, DRESSING IN AN APPROPRIATE LEVEL OF PPE AND PRACTICING DECONTAMINATION PATIENTS. RLMC ALSO SUPPORTS EFFORTS TO HAVE THE SAFE REMOVAL AND TREATMENT OF GARBAGE AND WASTE PRODUCTS. |
| PART III, LINE 2: | THE AMOUNT REPORTED ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THE RESPECTIVE CLASS OF PATIENTS. |
| PART III, LINE 3: | THE HOSPITAL DOES NOT HAVE A WAY TO REASONABLY ESTIMATE THE AMOUNT OF IMPLICIT PRICE CONCESSIONS THAT ARE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY FOOTNOTE (PAGE 11 OF AUDITED FS) -PATIENT ACCOUNTS RECEIVABLE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE CENTER EXPECTS TO BE ENTITLED, IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE CENTER ESTIMATES THE TRANSACTION PRICE BASED ON, NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.THE CENTER DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. |
| PART III, LINE 8: | RLMC IS A CRITICAL ACCESS HOSPITAL. THERE WAS A SURPLUS IN 2022, HOWEVER, REGARDLESS OF SHORTFALL OR SURPLUS, THE HOSPITAL PROVIDES SERVICES TO THESE PATIENTS BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT TO THE HOSPITAL. MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE 2022 MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | RLMC WILL NOT REFER AN ACCOUNT TO A THIRD-PARTY DEBT COLLECTION AGENCY UNLESS RLMC HAS GIVEN THE PATIENT REASONABLE OPPORTUNITY TO SUBMIT A FINANCIAL ASSISTANCE APPLICATION IF THE FACTS AND CIRCUMSTANCES SUGGEST THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. INCLUDING FOR EXAMPLE, IF THE PATIENT IS UNINSURED OR IS ON MINNESOTA CARE, MEDICAL ASSISTANCE, OR OTHER RELIEF BASED ON NEED. IF A PATIENT SUBMITS AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, RLMC WILL SUSPEND ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S APPLICATION HAS BEEN PROCESSED AND THE PATIENT HAS BEEN NOTIFIED OF THE DECISION. |
| PART VI, LINE 2: | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED EVERY 3 YEARS, COMMUNITY HEALTH FAIRS ARE HELD WHERE COMMUNITY MEMBERS CAN PROVIDE FEEDBACK ON THEIR HEALTH CARE NEEDS. A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) HAS ALSO BEEN FORMED WHICH PROVIDES A LINK BETWEEN THE COMMUNITY AND THE ORGANIZATION. RLMC HAS A LARGE FOOTPRINT WITHIN THE COMMUNITY WITH INVOLVEMENT IN MANY SERVICE AND COMMUNITY BASED GROUPS, SPONSORING THE COMMUNITY CHRISTMAS PARADE, PLANNING ASSISTANCE WITH THE FOURTH OF JULY PARADE, SPONSORING HALLOWEEN "PUMPKINPALOOSA", AND CONTRIBUTING SUPPORT TO MANY LOCAL HEALTH AND EDUCATION RELATED PROGRAMS. |
| PART VI, LINE 3: | RLMC HAS STAFF THAT ARE CERTIFIED MNSURE NAVIGATORS, WHICH ENABLES US TO ASSIST OUR PATIENTS IN COMPLETING THE APPLICATION PROCESS ON THE HEALTH EXCHANGE TO SEE IF THEY QUALIFY FOR INSURANCE OR A MEDICAID PLAN. RLMC COMMUNICATES OUR FINANCIAL ASSISTANCE PROGRAM TO PATIENTS IN THE FOLLOWING MANNER: 1. PATIENTS ARE GIVEN A FINANCIAL ASSISTANCE BROCHURE WITH A MNSURE HEALTH EXCHANGE INSERT AT THE TIME OF SERVICE. 2. STATEMENTS AND LETTERS ARE SENT TO PATIENTS OFFERING FINANCIAL ASSISTANCE. 3. PHONE CALLS ARE MADE TO PATIENTS TO DISCUSS AND OFFER FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE MNSURE APPLICATION PROCESS. 4. ALL EMPLOYEES ARE EDUCATED ANNUALLY ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND THREE EMPLOYEES ARE EDUCATED TO COMPLETE AND SUBMIT MNSURE APPLICATIONS TO THE STATE FOR PROCESSING. 5. UPON REQUEST, FINANCIAL ASSISTANCE PACKETS WITH APPLICATIONS FOR BOTH OUR FINANCIAL ASSISTANCE PROGRAM AND THE MNSURE PROGRAM ARE SENT OR GIVEN TO PATIENTS. 6. THE RLMC WEBSITE DISPLAYS PAYMENT OPTIONS WHERE OUR FINANCIAL ASSISTANCE PROGRAM IS DISCUSSED. 7. ONE OF THE REQUIREMENTS FOR RLMC FINANCIAL ASSISTANCE IS A DENIAL FROM THE COUNTY IN REGARD TO FINANCIAL ASSISTANCE UNLESS THEY ARE ENROLLED IN THE MN SENIOR PROGRAM. WE OFFER TO ASSIST THEM WITH THEIR MEDICAL ASSISTANCE APPLICATION. 8. SIGNAGE COMMUNICATING THE PROGRAM TO PATIENTS IS DISPLAYED IN MANY AREAS OF THE PATIENT CARE AREA OF THE FACILITY. 9. FINANCIAL COUNSELORS ATTEND HEALTH FAIRS AND OTHER EVENTS IN THE COMMUNITY TO PROMOTE THE PROGRAM AND ANSWER ANY QUESTIONS. 10. RLMC HAS PARTNERED WITH NUMEROUS COMMUNITY SERVICE PARTNERS TO PROMOTE OUR FINANCIAL ASSISTANCE PROGRAM AND MNSURE NAVIGATOR AVAILABILITY. THE COMMUNITY SERVICE PARTNERS ARE GIVEN FINANCIAL ASSISTANCE AND MNSURE INFORMATION TO SHARE WITH THEIR PATRONS AND BUSINESS CARDS OF OUR FINANCIAL COUNSELING STAFF. RLMC STAFF MEETS WITH OUR SERVICE PARTNERS FOR INPUT REGARDING OUR PROGRAMS, TO REPLENISH BROCHURES AND INFORMATION AND TO UPDATE THEM WITH ANY CHANGES. |
| PART VI, LINE 4: | RLMC'S PRIMARY SERVICE AREA (PSA) IS KOOCHICHING COUNTY, MINNESOTA. THE COUNTY IS LARGE AND SPARSELY POPULATED (LESS THAN 3.9 PERSONS PER SQUARE MILE) WITH MOST OF THE POPULATION CENTERED IN INTERNATIONAL FALLS. OTHER NEARBY COMMUNITIES INCLUDE LITTLEFORK, BIG FALLS, RANIER, BIRCHDALE AND LOMAN. THE PSA HAS AN ESTIMATED POPULATION OF APPROXIMATELY 12,000 AND POPULATION DECLINE IS PROJECTED TO CONTINUE WHILE THE NUMBER OF PERSONS OVER 65 IS EXPECTED TO REMAIN SIMILAR OF RISE EVEN MORE. |
| PART VI, LINE 5: | REPRESENTATION ON THE BOARD OF TRUSTEES IS 100% LOCAL AS ALL TRUSTEES ARE ACTIVE AND INVOLVED MEMBERS OF THE LOCAL COMMUNITY. RLMC HAS IN PLACE AN OPEN MEDICAL STAFF MODEL AND HAS SPECIALISTS FROM SEVERAL DIFFERENT HEALTH CARE SYSTEMS PROVIDING CARE TO PATIENTS. THE ORGANIZATION HAS RECENTLY INVESTED OVER $8 MILLION IN EXPANSION AND RENOVATION OF THE CURRENT FACILITY IN ORDER TO PROVIDE BETTER PATIENT CARE AND MORE LOCAL CARE, ELIMINATING THE NEED TO TRAVEL 100+ MILES TO RECEIVE CARE. THE ORGANIZATION ALSO CONTINUES TO EXPAND THE BREADTH OF SPECIALTY SERVICES OFFERED LOCALLY ON AN OUTREACH BASIS. EMERGENCY SERVICES ARE OFFERED 24/7, 365 DAYS A YEAR TO ALL NEEDING CARE. BECAUSE OF ITS REMOTE LOCATION, IF CHEMOTHERAPY SERVICES WERE NOT OFFERED IN THE COMMUNITY, RESIDENTS WOULD HAVE TO TRAVEL 100+ MILES TO RECEIVE THIS CRITICAL SERVICE. THE ORGANIZATION RECENTLY ESTABLISHED A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) TO ALLOW FOR COMMUNITY INPUT. EACH FALL A COMMUNITY HEALTH FAIR IS CONDUCTED IN CONJUNCTION WITH OTHER HEALTHCARE PROVIDERS WITHIN THE COMMUNITY TO ENCOURAGE VACCINATIONS, WELLNESS, AND OTHER PREVENTATIVE SERVICES. |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID MOYER | ||||||||||||||
| PHYSICIAN | $355,084 | $0 | $1,000 | $0 | $714 | $0 | $6,746 | $0 | $13,497 | $0 | $377,041 | $0 | $0 | $0 |
| ROBERT PASTOR II | ||||||||||||||
| CEO | $286,579 | $0 | $13,000 | $0 | $6,152 | $0 | $17,912 | $0 | $34,525 | $0 | $358,168 | $0 | $0 | $0 |
| DANIEL MARGO | ||||||||||||||
| GENERAL SURGEON | $313,366 | $0 | $500 | $0 | $0 | $0 | $8,158 | $0 | $29,133 | $0 | $351,157 | $0 | $0 | $0 |
| JAY KNAAK | ||||||||||||||
| PHYSICIAN | $247,949 | $0 | $5,800 | $0 | $715 | $0 | $6,715 | $0 | $36,540 | $0 | $297,719 | $0 | $0 | $0 |
| SCOTT JOHNSON | ||||||||||||||
| PHYSICIAN | $161,536 | $0 | $500 | $0 | $0 | $0 | $23,287 | $0 | $0 | $0 | $185,323 | $0 | $0 | $0 |
| AMBER BIONDICH | ||||||||||||||
| NURSE PRACTITIONER | $109,267 | $0 | $39,752 | $0 | $12,688 | $0 | $3,705 | $0 | $1,311 | $0 | $166,723 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREA PASTOR | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER OF CEO | RelationshipDescriptionTxt |
| Transaction | $82,346 | TransactionAmt |
| Transaction | EMPLOYEE/COMPENSATION | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE SAME ACCOUNTING FIRM WHICH PREPARES THE AUDIT AND THEN IT IS REVIEWED BY THE CFO AND CEO. IN ADDITION, A COPY OF THE RETURN IS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REMINDED OF THE CONFLICT OF INTEREST POLICY AND MUST SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. WHEN A CONFLICT OF INTEREST EXISTS, THE INTERESTED TRUSTEE MAY BE PRESENT FOR DISCUSSION TO ANSWER QUESTIONS BUT MAY NOT ADVOCATE FOR THE ACTION TO BE TAKEN AND MAY BE ASKED TO LEAVE THE ROOM WHILE A VOTE IS TAKEN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO'S INITIAL COMPENSATION FOR THE CURRENT CONTRACT AND ANY SUBSEQUENT ANNUAL INCREASES BASED ON PERFORMANCE ARE SET BY THE BOARD OF DIRECTORS AND IS DOCUMENTED IN THE BOARD MINUTES. CEO COMPENSATION RATE AND INCREASES ARE DETERMINED USING EXTERNAL SALARY RANGE REPORTS: THE MINNESOTA HOSPITAL ASSOCIATION SALARY SURVEY REPORT, THE "HHRAM" (HEALTHCARE HUMAN RESOURCES ASSOCIATION OF MINNESOTA) SALARY SURVEY BOOK, AND THE MEDICAL GROUP MANAGEMENT ASSOCIATE (MGMA) PHYSICIAN COMPENSATION REPORT SURVEY. THE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES IS ALSO DETERMINED USING AT LEAST AT LEAST ONE OF THE ABOVE MENTIONED EXTERNAL SALARY RANGE REPORTS AS APPLICABLE TO THE POSITION. THESE RATES AND ANY INCREASES ARE APPROVED BY THE CEO AND PRESENTED TO THE BOARD OF DIRECTORS FOR THEIR APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT OPEN TO THE PUBLIC. |
| PART VII, SECTION A, LINE 1A | MELISSA MARCOTTE SERVED AS THE CFO THROUGH FEBRUARY OF 2022 FOR A PARTIAL YEAR AS AN OFFICER. THE AMOUNT REFLECTED IN PAGE 7, COLUMN D INCLUDES HER TIME BOTH DEVOTED AS AN OFFICER, AND NOT AS AN OFFICER, TO TIE TO HER REPORTABLE COMPENSATION PER BOX 5 OF FORM W-2. |
| FORM 990, PART IX, LINE 11G | ANESTHESIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 524,762. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 524,762. DIETARY SERVICES: PROGRAM SERVICE EXPENSES 136,199. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 136,199. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 288,149. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 288,149. OTHER SERVICES: PROGRAM SERVICE EXPENSES 835,810. MANAGEMENT AND GENERAL EXPENSES 486,638. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,322,448. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,631,703. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,631,703. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 84,583. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,583. |
| FORM 990, PART XI, LINE 9: | CHANGE IN UNRECOGNIZED PENSION COSTS 58,048. OTHER ADJUSTMENT |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FALLS MEMORIAL HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 HIGHWAY 71 | AddressLine1Txt |
| City | INTERNATIONAL FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204585807 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INTERNATIONAL FALLS MEMORIAL HOSPITAL ASSOCATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FALLS MEMORIAL HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $66,973 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
Comments