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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14515</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BRANT HACKER MD</PersonNm>
        <TitleTxt>MEDICAL DOCTOR</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>111652</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARIA NOLTE MD</PersonNm>
        <TitleTxt>MEDICAL DOCTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>LAURA HONG MD</PersonNm>
        <TitleTxt>MEDICAL DOCTOR</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL DEYO PA</PersonNm>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>MN</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
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        <ContractorAddress>
          <USAddress>
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      <ContractorCompensationGrp>
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      <ContractorCompensationGrp>
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          <USAddress>
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      <OtherRevenueMiscGrp>
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      <TotalRevenueGrp>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>280349</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <EOYAmt>2630</EOYAmt>
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          <State>RESTRICTED</State>
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        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>MADISON HEALTHCARE SERVICES IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MINNESOTA HOSPITAL ASSOCIATION (MHA). A PORTION OF THEIR DUES ARE FOR LOBBYING EXPENSES. THE AHA INVESTS CONSIDERABLE DUES RESOURCES ON A BROAD RANGE OF ADVOCACY AND REPRESENTATION INITIATIVES TO HELP THE FIELD UNDERSTAND AND RESPOND TO THE LEGISLATIVE AND REGULATORY CHANGES ON THE HORIZON AND TO SUPPORT HOSPITALS AS THEY STRIVE TO DELIVER AN EVEN HIGHER QUALITY OF CARE IN THE FACE OF THOSE CHANGES. THE MHA WORKS TO DEVELOP, PROMOTE, AND IMPLEMENT HEALTH CARE POLICY AT THE STATE AND FEDERAL LEVELS OF GOVERNMENT TO BENEFIT HOSPITAL PATIENTS, EMPLOYEES, AND COMMUNITIES. THEIR GOVERNMENT RELATIONS OFFICERS WORK CLOSELY WITH MEMBERS TO BRING HOSPITALS' CONCERNS TO ST. PAUL, MINNESOTA AND WASHINGTON D.C. MHA PARTNERS WITH HEALTH CARE PROVIDERS, COMMUNITY GROUPS, AND OTHER STAKEHOLDERS TO ADVANCE THEIR COMMON INTERESTS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>PART IV, LINE 2B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NURSING CARE CENTER RESIDENT TRUST FUND IS USED BY RESIDENTS AND/OR THEIR FAMILIES TO DEPOSIT MONEY INTO A SEPARATE CHECKING ACCOUNT. THE RESIDENTS CAN WITHDRAW THESE FUNDS AT ANY TIME FOR CARE SERVICES, GIFT SHOP PURCHASES, CASH FOR SODA, CANDY OR GIFTS, ETC.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>BASED ON AN EVALUATION OF ITS TAX POSITIONS, THE ORGANIZATION HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF SEPTEMBER 30, 2019 AND 2018. THE ORGANIZATION'S FEDERAL INFORMATIONAL RETURNS FOR TAX YEARS 2015 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE IRS.</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>MADISON HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: THE HOSPITAL CONDUCTED A COMMUNITY SURVEY, INTERVIEWED PROVIDERS AT OUR FACILITY, MEMBERS IN THE COMMUNITY OF MADISON, AND CONSISTENTLY MET WITH A PUBLIC HEALTH NURSE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>MADISON HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6B: MADISON HEALTHCARE SERVICES PARTNERED WITH COUNTRYSIDE PUBLIC HEALTH, PRAIRIE FIVE RIDES, LAC QUI PARLE COUNTY FAMILY SERVICE CENTER, LAC QUI PARLE COUNTY COMMISSIONERS, LAC QUI PARLE VALLEY SCHOOL DISTRICT, AND THE CITY OF MADISON IN ORDER TO ADDRESS TEH HEALTH NEEDS OF THE REGION.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>MADISON HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: ONE OF THE PRIMARY FOCUSES OF ANY HEALTHCARE FACILITY IS IDENTIFYING AND ADDRESSING THE HEALTH NEEDS OF THE AREA THEY SERVE. MADISON HEALTHCARE SERVICES (MHS) HAS PUT FORTH TIME, EFFORT, AND RESOURCES TO DOING JUST THAT. AS A NON-PROFIT FACILITY, MHS IS DEDICATED TO REINVESTING IN OUR HEALTHCARE SYSTEM TO MEET THE NEEDS OF THE COMMUNITIES WE PROVIDE SERVICES TO. MADISON HEALTHCARE SERVICES CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT ON THE COUNTY OF LAC QUI PARLE IN MINNESOTA, WHERE THE MAJORITY OF OUR PATIENTS RESIDE. WE UTILIZED ADDITIONAL RESOURCES INCLUDING THE MINNESOTA DEPARTMENT OF HEALTH, AND COUNTRYSIDE PUBLIC HEALTH TO FURTHER OUR ASSESSMENT. WE FINISHED OUR EVALUATION WITH PRIMARY DATA WE COMPILED THROUGH A COMMUNITY SURVEY. WE COLLABORATED WITH COUNTRYSIDE PUBLIC HEALTH, PRAIRIE FIVE RIDES, LAC QUI PARLE COUNTY FAMILY SERVICE CENTER, LAC QUI PARLE COUNTY COMMISSIONERS, LAC QUI PARLE VALLEY SCHOOL DISTRICT, AND THE CITY OF MADISON. USING ALL THIS INFORMATION, OUR COMMUNITY HEALTH NEEDS COMMITTEE DETERMINED THE HEALTH NEEDS FOR THE COUNTY. THE COMMITTEE IDENTIFIED TWO MAIN HEALTH NEEDS IN OUR AREA WHICH ARE BACK/JOINT PAIN AND MENTAL HEALTH. OUR AREA EXPERIENCES LACK OF EDUCATION, LOCAL OUTREACH PROVIDER SERVICES TO TREAT THESE CONDITIONS, AND PREVENTION WHEN FACING THESE PROBLEMS. SINCE WE ARE LOCATED IN A RURAL AREA, WE REALIZE THE IMPORTANCE OF COLLABORATING WITH LOCAL MEMBERS OF OUR COMMUNITIES, PUBLIC HEALTH OFFICIALS, AND NUMEROUS ORGANIZATIONS TO ADDRESS HEALTH CONCERNS IN THE REGION. TOGETHER, WE CAN RECOGNIZE WHERE IMPROVEMENTS ARE NEEDED AND STRIVE TO INCREASE THE QUALITY OF CARE WE PROVIDE TO OUR PATIENTS. IN ORDER TO ADDRESS THESE CHRONIC AND ACUTE DISEASES, WE WANT TO POSITIVELY INFLUENCE THE HEALTH HABITS OF PEOPLE IN OUR REGION BY PROVIDING EDUCATION ON PREVENTING AND MANAGING THEM.BACK AND JOINT PAIN HAVE BEEN AN ONGOING ISSUE IN OUR COMMUNITY AND WILL BE A CONTINUED AREA OF FOCUS FOR OUR COMMITTEE. MADISON HEALTHCARE SERVICES IS STRIVING TO PROVIDE THE SERVICES AND PROCEDURES NEEDED TO RELIEVE BACK AND JOINT PAIN SO ONE CAN GET BACK TO THE ACTIVITIES THAT HE/SHE ENJOYS. MADISON HEALTHCARE SERVICES HAS ADDED NEW ORTHOPEDIC SERVICES TO ITS LONG LIST OF SPECIALTY SERVICES. WITH THE ADDITION OF THIS NEW ORTHOPEDIC SURGEON, MADISON HEALTHCARE SERVICES WILL BE ABLE TO OFFER TOTAL JOINT REPLACEMENTS, PARTIAL JOINT REPLACEMENTS AND A VARIETY OF JOINT INJECTION PROCEDURES TO HELP RELIEVE JOINT PAIN. PATIENTS WILL NOW BE ABLE TO HAVE JOINT REPLACEMENT SURGERY, RECOVERY AND PHYSICAL THERAPY RIGHT IN THEIR COMMUNITY WITHOUT THE NEED TO TRAVEL FOR THESE SERVICES. IN ADDITION TO OUR ORTHOPEDIC SURGERY OPTIONS, MHS OFFERS PAIN INJECTION PROCEDURES PERFORMED BY AN INTERVENTIONAL RADIOLOGIST ON A MONTHLY BASIS. PAIN INJECTION PROCEDURES ARE PERFORMED TO HELP ALLEVIATE SEVERE NECK AND BACK PAIN AND OFFER A GREAT ALTERNATIVE TO NARCOTIC PRESCRIPTION USE. TO FURTHER EXPAND NON-SURGICAL TREATMENTS FOR JOINT AND BACK PAIN, OUR THERAPY DEPARTMENT RECENTLY RECEIVED CERTIFICATIONS IN THERAPEUTIC PAIN RELIEF. MADISON HEALTHCARE SERVICES FURTHER IDENTIFIED MENTAL HEALTH AS A GAP IN OUR COMMUNITY. MADISON HEALTHCARE SERVICES IS WORKING TO ADDRESS THIS NEED FURTHER. THE LAC QUI PARLE HEALTH NETWORK (LQPHN), TOGETHER WITH WOODLAND CENTERS, RECEIVED A GRANT TO IMPROVE THE ACCESS FOR BEHAVIORAL HEALTH PATIENTS IN OUR COMMUNITY BY INTEGRATING BEHAVIORAL HEALTH INTO FAMILY PRACTICE AND TO REDUCE THE STIGMA OF MENTAL HEALTH USING MARKETING AND EDUCATION CAMPAIGNS. IN APRIL OF 2019, MADISON HEALTHCARE SERVICES ADDED A PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER TO OUR FAMILY PRACTICE TWO DAYS A MONTH. WE THEN ADDED MENTAL HEALTH COUNSELING SERVICES WEEKLY STARTING IN JULY OF 2019. IN ADDITION TO IMPROVING ACCESS TO BEHAVIORAL HEALTH SERVICES FOR OUR PATIENTS, WE ARE AGGRESSIVELY MARKETING TO THE COMMUNITY TO REDUCE THE STIGMA AND INCREASE THEIR AWARENESS OF SERVICES. WE ARE OFFERING EDUCATIONAL OPPORTUNITIES TO BOTH STAFF AND THE COMMUNITY AT LARGE SUCH AS THE "MAKE IT OK CAMPAIGN" AT OUR HIGH SCHOOL AND COMMUNITY EVENTS, ALLOWING STUDENTS, STAFF, ETC. TO SIGN A PLEDGE.VARIOUS SPEAKERS ARE LINED UP FOR THE UPCOMING YEAR INCLUDING AMY DEE FOR THE COMMUNITY AND STAFF, AND TED MATTHEWS, FROM THE MN DEPARTMENT OF AGRICULTURE FOR MINNESOTA FARMERS, TO TALK WITH ANYONE WORKING WITH FARMERS SUCH AS THROUGH FINANCE, CHURCH, HEALTHCARE PROVIDERS, ETC TO MAKE THEM AWARE OF FARMER COUNSELING NEEDS AND THE STRESSORS THROUGH FARMING. WE WILL CONTINUE WITH STAFF TRAINING AND DEVELOPMENT THROUGH LUNCH AND LEARNS AND NONVIOLENT CRISIS INTERVENTION(CPI). MHS WILL COLLABORATE WITH THE AREA SCHOOLS WITH THE "WALK A MILE IN OUR SHOES CAMPAIGN" FOR HIGH SCHOOL STUDENTS AND WORKING ON POSITIVE CHARACTER TRAITS FOR MIDDLE AND ELEMENTARY STUDENTS. THE PLAN GOING FORWARD IS TO MARKET FOR SUICIDE PREVENTION AWARENESS MONTH AND OTHER ACTIVITIES SUCH AS "WIN WITH WELLNESS BINGO" THAT WE HAVE UTILIZED IN THE PAST.COMMUNITY WELLNESSMADISON HEALTHCARE SERVICES PARTICIPATED IN THE WELLNESS BINGO CHALLENGE. IN THE FALL OF 2019, THE LAC QUI PARLE HEALTH NETWORK ONCE AGAIN CHALLENGED THE MADISON, DAWSON, AND APPLETON COMMUNITIES TO GET HEALTHIER BY PLAYING WIN WITH WELLNESS BINGO. THE CARDS PROVIDED TIPS FOR IMPROVING THE HEALTH HABITS AND BEHAVIORS FOR THOSE THAT JOINED THE CHALLENGE. EACH BINGO CARD HAD UP TO 12 OPPORTUNITIES TO COMPLETE A BINGO. TO KEEP PARTICIPANTS MOTIVATED AT THE END OF EACH MONTH THEY PUT THEIR NAME IN FOR PRIZES FOR EACH BINGO THEY RECEIVED THAT MONTH AND HAD A GRAND PRIZE AT THE CONCLUSION OF THE CHALLENGE.DIRECT ACCESS LABIN ORDER TO ADDRESS THE UNINSURED, LOW-INCOME, AND MINORITY GROUPS, BY LAW OUR HOSPITAL CANNOT REFUSE TO SEE ANYONE REGARDLESS OF THEIR ABILITY TO PAY. THE DIRECT ACCESS LAB PROGRAM ALLOWS CASH PAYMENT FOR LAB SERVICES WITHOUT A PROVIDERS ORDERS AND IS ANOTHER SOURCE FOR THOSE WHO ARE UNINSURED AND WANT LAB WORK PERFORMED AT A LOWER COST. MADISON HEALTHCARE SERVICES ALSO OFFERS A 10% OFF UNINSURED DISCOUNT THEY ARE ABLE TO RECEIVE FOR GETTING SERVICES HERE.MHS CLINIC RECERTIFIED AS HEALTHCARE HOMETHE MINNESOTA DEPARTMENT OF HEALTH HAS RECERTIFIED THE LAC QUI PARLE CLINIC AS A HEALTH CARE HOME. THIS MEANS THAT THE CLINIC HAS MET A SET OF RIGOROUS STANDARDS TO PROVIDE PATIENT AND FAMILY-CENTERED CARE AND IS WORKING TO IMPROVE BOTH THE OVERALL QUALITY AND AFFORDABILITY OF HEALTHCARE. CHRONIC CARE MANAGEMENT IS THE CENTERPIECE OF THIS PROJECT IN THE CLINIC AND GIVES PATIENTS WITH TWO OR MORE CHRONIC CONDITIONS ACCESS TO NURSES TO HELP COORDINATE THEIR CARE AND PROVIDES ADVICE AND WELLNESS CHECKS.UPGRADED EQUIPMENTMADISON HEALTHCARE SERVICES STRIVES TO PROVIDE PATIENTS ACCESS TO THE BEST MEDICAL EQUIPMENT IN THE REGION. MADISON HEALTHCARE SERVICES IN COLLABORATION WITH THE LEONA HELMSLEY CHARITABLE TRUST WAS ABLE TO PROCURE $330,000 WORTH OF UPGRADED DIGITAL X-RAY EQUIPMENT INCLUDING A NEW PORTABLE X-RAY MACHINE. UPGRADES IN THE LAB DEPARTMENT SAW THE ADDITION OF FOUR NEW ANALYZERS IN CHEMISTRY, HEMATOLOGY, IMMUNOLOGY AND COAGULATION. NEW EQUIPMENT WAS PURCHASED FOR ORTHOPEDIC SURGERY AS WELL AS OPHTHALMOLOGY EQUIPMENT TO PREFORM LASER CATARACT SURGERY.</ExplanationTxt>
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        <FormAndLineReferenceDesc>MADISON HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 13H: IF THE APPLICATION IS NOT RETURNED OR RETURNED INCOMPLETE, OTHER PATIENT MARKERS CAN BE USED TO APPROVE THE PATIENT FOR CHARITY CARE, SUCH AS WIC, FOOD STAMPS, FREE LUNCHES, MEDICAL ASSISTANCE, AND LOW-INCOME HOUSING. PATIENTS WHO MEET PRESUMPTIVE ELIGIBILITY CRITERIA MAY BE GRANTED FINANCIAL ASSISTANCE WITHOUT COMPLETING AN APPLICATION.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>MADISON HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 16J: WHEN IT HAS BEEN DISCOVERED THAT PATIENTS ARE HAVING DIFFICULTIES PAYING THEIR BILL AND PRIVATE PAY PATIENTS NOT MAKING PAYMENTS, THE PATIENT IS CALLED TO MAKE PAYMENT ARRANGEMENTS AND UPON DISCUSSION WITH THEM, THE HOSPITAL WILL MAIL THEM THE CHARITY CARE APPLICATION. IN ADDITION, ON THE ORGANIZATION'S WEBSITE UNDER THE FINANCIAL INFORMATION PAGE IT IS INDICATED THAT AN APPLICATION FOR CHARITY CARE IS AVAILABLE AND THAT ASSISTANCE WITH THE APPLICATION FOR FINANCIAL ASSISTANCE IS AVAILABLE UPON REQUEST.</ExplanationTxt>
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          <BusinessName>
            <BusinessNameLine1Txt>1 - LAC QUI PARLE CLINIC</BusinessNameLine1Txt>
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            <AddressLine1Txt>900 SECOND AVENUE</AddressLine1Txt>
            <CityNm>MADISON</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>56256</ZIPCd>
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          <FacilityTxt>CLINIC</FacilityTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3C:</FormAndLineReferenceDesc>
        <ExplanationTxt>FOR A PERSON TO QUALIFY FOR CHARITY CARE UNDER MADISON HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICY, AN INDIVIDUAL MUST RESIDE WITHIN A 50-MILE RADIUS OF THE HOSPITAL, HAVE FAMILY NET ASSETS LESS THAN $10,000, HAVE INCOME BELOW 27% OF FEDERAL POVERTY GUIDELINES, AND EITHER SUBMIT A COMPLETE APPLICATION OR BE PROVEN TO QUALIFY THROUGH PRESUMPTIVE DETERMINATIONS. AN INDIVIDUAL IS PRESUMPTIVELY ELIGIBLE FOR ASSISTANCE IF THEY EXPIRE WITHOUT AN ESTATE, WERE ON MEDICAL ASSISTANCE OR SIMILAR COVERAGE WITHIN THE PAST 12 MONTHS AND HAVE NO CHANGE IN EMPLOYMENT STATUS, OR FILED AND WERE APPROVED FOR BANKRUPTCY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNTS IN LINES 7A AND 7B WERE CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 IN THE SCHEDULE'S INSTRUCTIONS. LINE 7E WAS CALCULATED AT CLOSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7, COLUMN (F):</FormAndLineReferenceDesc>
        <ExplanationTxt>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 $ 75,399.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, COMMUNITY BUILDING ACTIVITIES:</FormAndLineReferenceDesc>
        <ExplanationTxt>MADISON HOSPITAL DOES ULTRASOUND SCREENINGS AT REDUCED RATES TWICE A YEAR AND HAS A VARIETY OF LAB TESTS AT REDUCED RATES (DIRECT-ACCESS LAB), AS WELL AS OTHER COMMUNITY BUILDING ACTIVITIES. MANY OF THE COMMUNITY BUILDING ACTIVITIES ARE NOT EASY OR COST EFFECTIVE TO TRACK IN THE ACCOUNTING SYSTEM AND ARE THEREFORE NOT REPORTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE IS CALCULATED UTILIZING DIRECT BAD DEBT COSTS FROM NONPAYMENT AFTER CONTRACTUAL DISCOUNTS AND PAYMENTS HAVE BEEN RECEIVED. THE STANDARD FORMULA FOR ACCOUNTS RECEIVABLE HAS BEEN UTILIZED FOR ANY OUTSTANDING ACCOUNTS AFTER CONTRACTUAL DISCOUNTS WERE TAKEN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>DUE TO THE PUBLIC SHOWING, ADVERTISEMENT, PREQUALIFICATION, AND FOLLOW-UP NOTIFICATIONS OF OUR FINANCIAL ASSISTANCE POLICY VIA OUR BILLING PROCEDURES, WE DO NOT FEEL THAT THE IMPACT IS ABOVE ZERO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S BAD DEBT EXPENSE IS DISCUSSED IN THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE" SECTION OF NOTE 1 TO THE FINANCIAL STATEMENTS, ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICARE SHORTFALL OF $1,035,468 IS MADE UP MOSTLY OF PATIENT DEDUCTIBLES AND COINSURANCE. IF WE BACK THESE AMOUNTS OUT OF THE SHORTFALL, WE ARE LEFT WITH A TRUE SHORTFALL OF $82,650. THIS AMOUNT IS A RESULT OF THE FEDERAL GOVERNMENT'S SEQUESTRATION IMPLEMENTED BACK IN THE SUMMER OF 2016, OF WHICH WOULDN'T BE TREATED AS COMMUNITY BENEFIT.THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WERE DERIVED FROM THE 2019 FILED MEDICARE COST REPORT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>IF PATIENTS HAVE COMPLETED ALL PAPERWORK AND QUALIFY FOR CHARITY CARE, THE PATIENT IS NOT BILLED FOR ANY BALANCE AND ACCOUNT IS WRITTEN OFF. IF THE PATIENT HAS MEDICAL ASSISTANCE, THAT PROGRAM IS BILLED FOR CHARGES AND THE PAYMENT IS CONSIDERED PAYMENT IN FULL, UNLESS MEDICAL ASSISTANCE NOTIFIES US THAT THE PATIENT HAS RESPONSIBILITY FOR SPEND DOWN OR CO-PAY PAYMENTS.MADISON HEALTHCARE SERVICES WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE IF THE PERSON QUALIFIES FOR FINANCIAL ASSISTANCE. REASONABLE EFFORT WILL BE TAKEN TO REQUEST AND ASSIST IN COMPLETING APPLICATION, INCLUDING MEETING WITH INDIVIDUAL AND ASSISTING WITH THE APPLICATION PROCESS.IF THE INDIVIDUAL FAILS TO SUBMIT THE CHARITY CARE APPLICATION WITHIN 120 DAYS OF THE FIRST BILLING STATEMENT THE FACILITY HAS THE OPTION TO PROCEED WITH COLLECTION PROCESS. AT LEAST 30 DAYS PRIOR TO INITIATING THE COLLECTION PROCESS A WRITTEN NOTICE WILL BE PROVIDED INDICATING IF INDIVIDUAL DOES NOT SUBMIT THE APPLICATION OR PAY THE AMOUNT DUE BY INDICATED DEADLINE THE ACCOUNT WILL BE SENT TO A COLLECTION AGENCY. THE FACILITY HAS THE DISCRETION TO CONSIDER FOR CHARITY CARE WITHOUT COMPLETION OF CHARITY CARE APPLICATION.IF THE INDIVIDUAL COMPLETES THE APPLICATION WITHIN THE 240 DAY REQUIREMENT FOLLOWING TREATMENT, THE FACILITY WILL SUSPEND ANY COLLECTION EFFORTS. IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION WRITTEN NOTICE WILL BE PROVIDED WITH ADDITIONAL INFORMATION NEEDED AND REASONABLE TIME WILL BE GIVEN TO SUBMIT MISSING INFORMATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY MHS FIRST PERFORMED A DEMOGRAPHIC ANALYSIS OF LAC QUI PARLE COUNTY USING DATA FROM THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS. TO FURTHER THE ASSESSMENT ADDITIONAL RESOURCES WERE UTILIZED, INCLUDING THE MN DEPARTMENT OF HEALTH AND COUNTRYSIDE PUBLIC HEALTH. MHS FINISHED THE EVALUATION WITH PRIMARY DATA COMPILED THROUGH A COMMUNITY SURVEY. MHS COLLABORATED WITH COUNTRYSIDE PUBLIC HEALTH, PRAIRIE FIVE RIDES, LAC QUI PARLE COUNTY FAMILY SERVICE CENTER, LAC QUI PARLE COUNTY COMMISSIONERS, LAC QUI PARLE VALLEY SCHOOL DISTRICT, AND THE CITY OF MADISON. USING THE INFORMATION COLLECTED, THE COMMUNITY HEALTH NEEDS COMMITTEE DETERMINED THE HEALTH NEEDS FOR THE COUNTY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THESE PROGRAMS IN THE PATIENT ADMISSION PACKET AND ON THE HOSPITAL'S WEBSITE. THE WEBSITE INDICATES THE HOSPITAL WILL FILE YOUR INSURANCE CLAIMS, CAN SET UP AUTOMATIC BANK WITHDRAWALS, THE HOSPITAL ACCEPTS CREDIT CARD PAYMENTS, YOU CAN REQUEST CHARITY CARE APPLICATIONS, THE HOSPITAL DOES NOT CHARGE FINANCE CHARGES, THE HOSPITAL ACCEPT PAYMENT ARRANGEMENTS, ITEMIZED BILL AVAILABLE UPON REQUEST AND GLAD TO ANSWER YOUR QUESTIONS.THE HOSPITAL SENDS 3 STATEMENTS TO PATIENTS WITH PRIVATE PAY BALANCES, ALSO SENDS 3 LETTERS INDICATING PAST DUE BALANCE AND TO PLEASE PAY OR YOUR ACCOUNT WILL BE SENT TO COLLECTION. MANY TIMES A PHONE CALL IS MADE TO PATIENT ASKING THEM TO SET UP PAYMENT ARRANGEMENT OR ASKING IF THEY WANT CHARITY CARE APPLICATION OR HOW THE HOSPITAL CAN ASSIST THEM TO GET THEIR BALANCE PAID PRIOR TO SENDING TO COLLECTION AGENCY. THE PAST DUE LETTERS SENT TO PATIENTS REQUEST THEM TO CALL THE HOSPITAL TO DISCUSS THEIR PAST DUE BILL AT WHICH TIME THE ASSISTANCE PROGRAMS CAN BE EXPLAINED. THE HOSPITAL DOES NOT CHARGE FINANCE CHARGES TO PATIENTS' UNPAID BALANCE. THE ORGANIZATION BELIEVES THIS IS A COMMUNITY SERVICE AND ASSISTS THOSE PATIENTS THAT CAN ONLY MAKE SMALL PAYMENTS - OTHERWISE FINANCE CHARGES COULD BE MORE THAN THEIR MONTHLY PAYMENT AND DISCOURAGE THEM FROM MAKING ANY PAYMENTS.PRIVATE PAY INPATIENTS ARE VISITED BY OFFICE STAFF AND GIVEN FORMS TO APPLY FOR MEDICAL ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AREA BEING SERVED BY THE MADISON HOSPITAL AND LAC QUI PARLE CLINIC IS PRIMARILY A RURAL AND AGING COMMUNITY. THE PATIENT BASE IS MADE UP OF BOTH WORKING CLASS AND FARMERS. THE COUNTIES THAT WE SERVE ARE LAC QUI PARLE, BIG STONE AND SOME BORDER COUNTIES OF SOUTH DAKOTA. THE CLOSEST FACILITIES ARE 25 MILES AWAY IN CANBY, DAWSON, APPLETON OR ORTONVILLE. THE AVERAGE INDIVIDUAL INCOME IS APPROXIMATELY $50,195 GROSS. ON AVERAGE THE POVERTY LEVEL IN THE COUNTY IS ABOUT 9.8% WITH MANY PEOPLE BEING LAID OFF. THE PERCENTAGE OF FAMILIES ON MEDICAID IS APPROXIMATELY 35%, RECEIVING SOME TYPE OF MEDICAL ASSISTANCE OR COUNTY ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL'S BOARD IS COMPRISED OF PERSONS WHO RESIDE IN THE COMMUNITYAND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY SUCH AS DR. CLINT BONN, CHIROPRACTOR. DR. BONN UTILIZED MADISON HOSPITAL'S LABORATORY FOR DEPARTMENT OF TRANSPORTATION DRUG TESTING AND MADISON HOSPITAL'S RADIOLOGY FOR ALL X-RAYS AND CT STUDIES. THREE TIMES A YEAR, THE RADIOLOGY DEPARTMENT HOLDS VASCULAR SCREENINGS IN WHICH COMMUNITY MEMBERS MAY HAVE VASCULAR SCREENINGS TO DETECT STROKES, PERIPHERAL VASCULAR DISEASE, AND ABDOMINAL AORTIC ANEURYSMS. THIS IS A CASH-BASED SCREENING AND IS AVAILABLE AT A SUBSTANTIALLY REDUCED RATE AND A DOCTOR'S ORDER IS NOT REQUIRED. MADISON HOSPITAL'S LAB OFFERS DIRECT-ACCESS LAB TESTING TO ITS COMMUNITY MEMBERS. THIS IS A CASH-BASED PROGRAM WHERE LAB TESTS ARE OFFERED ON A CASH BASIS AT A SUBSTANTIALLY REDUCED RATE. LAST YEAR, OUR USERS SAVED OVER $12,000. MADISON HOSPITAL AND LAC QUI PARLE CLINIC DONATE ALL UNUSED MEDICAL EQUIPMENT TO A MISSION FOR MEDICAL USE. ALL EXPIRED LABORATORY SUPPLIES ARE SENT TO THE MEDICAL LAB TECHNICIAN PROGRAMS FOR USE IN THEIR STUDENT LABS. MADISON HOSPITAL IS CONSTANTLY STRIVING TO ADD NEW SERVICES, INCLUDING OUTREACH SERVICES TO BETTER SERVE THE NEEDS OF OUR COMMUNITY. A LEADERSHIP TEAM HAS BEEN FORMED TO MEET THE COMMUNITY NEEDS, CONTINUE TO LOOK AT ADDING NEW SERVICES, CONTINUE TO LOOK AT UPDATING OUR CURRENT FACILITY, AND ASK FOR COMMUNITY INVOLVEMENT IN FINAL DECISION MAKING. WITH OUR AGING POPULATION, WE STRIVE TO BRING THE SERVICES TO THE PATIENTS, RATHER THAN THE PATIENTS HAVING TO DRIVE HOURS FROM HOME TO GET THE SERVICES. MADISON HOSPITAL PROVIDED HEALTH CARE SCREENINGS AT REDUCED RATES TO THE COMMUNITY.MADISON HOSPITAL OFFERED A BREAST FEEDING CLASS FOR EXPECTING NEW MOTHERS TWICE DURING THE YEAR.MADISON HOSPITAL ADDED ANOTHER ORTHOPEDIC SURGEON WITH PLANS TO DO SOME TOTAL JOINT SURGERIES IN THE UPCOMING YEAR SO PATIENTS DO NOT HAVE TO TRAVEL AND CAN RECOVER CLOSER TO HOME. MADISON HOSPITAL ADDED A MENTAL HEALTH PROVIDER IN 2019 WHO PROVIDES SERVICES IN THE CLINIC TWO DAYS A MONTH. ADDITIONALLY, A NEW SOCIAL WORKER ADDED DURING THE YEAR WHO PROVIDES COUNSELING SERVICES ONE DAY A WEEK. THE HOSPITAL WAS RECERTIFIED IN 2019 AS A HEALTHCARE HOME, WHICH ALLOWS FOR COORDINATED CARE TO IMPROVE OVERALL HEALTH AND WELL-BEING TO THE PATIENTS. MADISON HOSPITAL UPDATE ITS DIGITAL X-RAY EQUIPMENT, INCLUDING A NEW PORTABLE DIGITAL X-RAY RESULTING IN MORE OPTIONS WHEN PERFORMING BEDSIDE IMAGING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>MN</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S MEMBERS ARE THE LUTHERAN CONGREGATIONS WITHIN THE COMMUNITY. THE MAJORITY OF THE MEMBERS MUST AT ALL TIMES BE CONGREGATIONS WITHIN THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA). EACH MEMBER CONGREGATION SHALL BE REPRESENTED AT MEETINGS OF THE MEMBERS BY THREE DELEGATES, SELECTED FROM THE COMMUNICANT MEMBERS OF THE CONGREGATION. ALL DELEGATES SHALL HAVE EQUAL VOTING RIGHTS AND VOTING BY PROXY SHALL BE PROHIBITED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S MEMBERS ARE THE LUTHERAN CONGREGATIONS WITHIN THE COMMUNITY. DELEGATES OF LUTHERAN CONGREGATIONS ELECT THE BOARD OF DIRECTORS OF MADISON HEALTHCARE SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>AMENDMENTS TO THE BYLAWS MUST BE APPROVED BY THE MEMBER CONGREGATION DELEGATES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MONITORS THE CONFLICT OF INTEREST POLICY AS CONFLICTS ARISE. IF ANY DIRECTOR OR EMPLOYEE OF THE ORGANIZATION HAS ANY DIRECT OR INDIRECT INTEREST IN, OR RELATIONSHIP WITH, ANY INDIVIDUAL OR ORGANIZATION THAT PROPOSES TO ENTER INTO ANY TRANSACTION WITH THE CORPORATION, INCLUDING BUT NOT LIMITED TO TRANSACTIONS INVOLVING: A. THE SALE, PURCHASE, LEASE OR RENTAL OF ANY PROPERTY OR OTHER ASSET; B. EMPLOYMENT OR RENDITION OF SERVICES, PERSONAL OR OTHERWISE; C. THE AWARD OF ANY CONTRACT SUCH PERSON SHALL GIVE NOTICE OF SUCH INTEREST OR RELATIONSHIP AND SHALL THEREAFTER REFRAIN FROM DISCUSSING OR VOTING ON THE PARTICULAR TRANSACTION IN WHICH HE HAS AN INTEREST, OR OTHERWISE ATTEMPTING TO EXERT ANY INFLUENCE ON THE CORPORATION, OR ITS COMPONENTS TO AFFECT A DECISION TO PARTICIPATE OR NOT PARTICIPATE IN SUCH TRANSACTION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION USES COMPARABILITY DATA FROM SURVEYS OF OTHER ORGANIZATIONS OF SIMILAR SIZE IN THE SURROUNDING AREAS TO DETERMINE COMPENSATION OF TOP MANAGEMENT AND OFFICERS OF THE ORGANIZATION. THE MEDISOTA SALARY SURVEY IS UTILIZED IN THIS DETERMINATION. THE BOARD OF DIRECTORS REVIEWS AND APPROVES PRESIDENT/CEO COMPENSATION ANNUALLY. THE PRESIDENT/CEO APPROVES THE COMPENSATION OF THE CFO.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>NURSING/OTHER PROFESSIONAL: PROGRAM SERVICE EXPENSES 3,265,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,265,260. CONSULTANTS: PROGRAM SERVICE EXPENSES 4,081. MANAGEMENT AND GENERAL EXPENSES 44. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,125.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HILLTOP RESIDENCE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>900 SECOND AVENUE</AddressLine1Txt>
          <CityNm>MADISON</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56256</ZIPCd>
        </USAddress>
        <EIN>411376605</EIN>
        <PrimaryActivitiesTxt>HOUSING FOR HANDICAPPED AND ELDERLY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MADISON HEALTHCARE SERVICES</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>