MAPLE GROVE HOSPITAL CORPORATION: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MAPLE GROVE HOSPITAL CORPORATION (EIN 20-8316475)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201823199349311632
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T14:11:17-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 S 6TH ST 2300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208316475 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAPLE GROVE HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MAPL | BusinessNameControlTxt |
| Phone | 7635811000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9875 HOSPITAL DRIVE | AddressLine1Txt |
| City | MAPLE GROVE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55369 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AARON BLOOMQUIST | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 7635205048 | PhoneNum |
| Signature | 2018-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAWRENCE H MOHR CPA | PreparerPersonNm |
| PTIN | P00447603 | PTIN |
| Phone | 6128764500 | PhoneNum |
| Preparation | 2018-11-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.88.188.75 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-14 | IPDt |
| IP Tm | 09:10:33 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2519A5C6D4FE43330A9B665C55E2C286A0409372 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANDREW COCHRANE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9875 HOSPITAL DRIVE | AddressLine1Txt |
| City | MAPLE GROVE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55369 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $196,171,559 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MAPLEGROVEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO EMPOWER OUR CUSTOMERS TO ACHIEVE THEIR BEST HEALTH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 1230 | TotalEmployeeCnt |
| Total Volunteers | 391 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $23,029 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,910 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $187,035,541 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $195,925,342 | CYProgramServiceRevenueAmt |
| PY Investment Income | $194,447 | PYInvestmentIncomeAmt |
| CY Investment Income | $237,307 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $187,253,017 | PYTotalRevenueAmt |
| CY Total Revenue | $196,171,559 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $65,023,159 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $70,305,142 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $101,954,370 | PYOtherExpensesAmt |
| CY Other Expenses | $98,963,494 | CYOtherExpensesAmt |
| PY Total Expenses | $166,977,529 | PYTotalExpensesAmt |
| CY Total Expenses | $169,268,636 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $20,275,488 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $26,902,923 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $178,680,301 | TotalAssetsBOYAmt |
| Total Assets EOY | $173,527,171 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $145,894,609 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $143,321,812 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,785,692 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,205,359 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO EMPOWER OUR CUSTOMERS TO ACHIEVE THEIR BEST HEALTH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $143,991,696 | ExpenseAmt |
| Revenue | $195,079,305 | RevenueAmt |
| Desc | MAPLE GROVE HOSPITAL IS A GENERAL, ACUTE CARE HOSPITAL PROVIDING EMERGENCY SERVICES, MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, AND PEDIATRIC SERVICES. MAPLE GROVE HOSPITAL'S MISSION IS EMPOWERING ITS CUSTOMERS TO ACHIEVE THEIR BEST HEALTH.IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, MAPLE GROVE HOSPITAL ALSO PROVIDES NUMEROUS COMMUNITY BENEFITS (AT NO COST OR BELOW COST) IN FURTHERANCE OF ITS CHARITABLE PURPOSE INCLUDING HEALTH RELATED EDUCATIONAL PROGRAMS: SAFETY FAIRS, CAR SEAT CLINICS, MENTAL HEALTH AND FIRST AID CLASSES, AND ASTHMA EDUCATION IN ELEMENTARY SCHOOLS. MAPLE GROVE HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COSTS TO RESIDENTS OF ITS COMMUNITY PRIMARILY THROUGH (A) THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES, AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED UNABLE TO PAY BECAUSE OF ECONOMIC FACTORS. IN ADDITION, MAPLE GROVE HOSPITAL CONTRIBUTES TO FUNDING MEDICAL CARE FOR THE UNINSURED THROUGH PAYMENT OF PATIENT SERVICES TAXES, WHICH INCLUDE THE MEDICAID SURCHARGE AND THE MINNESOTA CARE TAX ON CERTAIN NET REVENUE. | Desc |
| Total Program Service Expenses | $143,991,696 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 135 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1230 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | AARON BLOOMQUIST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7635205200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1Txt |
| City | ROBBINSDALE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55422 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| J KEVIN CROSTON MD | |||||||||
| BOARD CHAIR | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $965,781 | $46,407 | ||
| AARON BLOOMQUIST | |||||||||
| TREASURER | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $468,789 | $32,865 | ||
| ANDREW HOULTON MD | |||||||||
| DIRECTOR - PART YEAR | 2.00 | 50.00 | Yes (X) | $0 | $483,274 | $36,362 | |||
| JENNIFER CLOSE | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $423,351 | $28,981 | |||
| JEFF WICKLANDER | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $484,703 | $45,638 | |||
| JAMES HEREFORD | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAN FROMM | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| SAMANTHA HANSON | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $98,653 | $1,573 | |||
| ANDREW COCHRANE | |||||||||
| PRESIDENT | 50.00 | Yes (X) | $0 | $440,571 | $43,789 | ||||
| PAMELA DOORENBOS MD | |||||||||
| VP MEDICAL AFFAIRS | 50.00 | $359,993 | $0 | $20,092 | Yes (X) | ||||
| STEVEN HORSTMANN | |||||||||
| VP OPERATIONS | 50.00 | $159,111 | $67,181 | $9,427 | Yes (X) | ||||
| WENDY ULFERTS | |||||||||
| VP PATIENT CARE/ CHIEF NURSING OFFICER | 50.00 | $141,178 | $0 | $13,229 | Yes (X) | ||||
| KAREN HALL | |||||||||
| PHARMACIST | 50.00 | $185,116 | $0 | $25,500 | Yes (X) | ||||
| SARAH R JOHNSON | |||||||||
| MANAGER, PHARMACY | 50.00 | $168,508 | $0 | $24,535 | Yes (X) | ||||
| REBECCA THIESFELD RAUEN | |||||||||
| DIRECTOR, HUMAN RESOURCES | 50.00 | $169,048 | $0 | $25,579 | Yes (X) | ||||
| LEAH WANDERSEE | |||||||||
| DIRECTOR, PROCEDURAL CARE | 50.00 | $175,977 | $0 | $16,777 | Yes (X) | ||||
| FAITH ZWIRCHITZ | |||||||||
| DIRECTOR, WOMENS & CHILDREN'S | 50.00 | $174,497 | $0 | $10,713 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,533,428 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,432,303 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $381,467 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 68 | 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 |
|---|---|---|---|---|---|
| UNIVERSITY OF MINNESOTA PHYSICIANS | |||||
| 720 WASHINGTON AVE STE 200 | MINNEAPOLIS | MN | 55414 | PHYSICIAN SERVICES | $1,604,530 |
| ARAMARK HEALTHCARE FOOD | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 60673 | DIETARY | $1,338,167 |
| FAIRVIEW HEALTH SERVICES | |||||
| 2450 RIVERSIDE AVENUE | MINNEAPOLIS | MN | 55454 | PHYSICIAN SERVICES | $969,887 |
| FAVORITE HEALTHCARE STAFFING INC | |||||
| PO BOX 803356 | KANSAS CITY | MO | 64180 | STAFFING | $677,160 |
| CROTHALL LAUNDRY SERVICE INC | |||||
| 13028 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | LAUNDRY | $674,884 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $8,910 | AllOtherContributionsAmt |
| Total Contributions | $8,910 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT REVENUE | 621500 | $195,079,305 | $195,079,305 | |
| CONTRACT SERVICES | 900099 | $436,639 | $436,639 | |
| GIFT SHOP | 900099 | $255,124 | $255,124 | |
| CMS/EHR PAYMENTS & OTHER | 900099 | $107,769 | $107,769 | |
| ALL OTHER | 621910 | $46,505 | $46,505 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $195,925,342 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $237,307 | TotalRevenueColumnAmt |
| Exclusion | $237,307 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $196,171,559 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $195,079,305 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,083,344 | 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 | $699,019 | TotalAmt |
| Management And General | $699,019 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,079,147 | TotalAmt |
| Program Services | $47,229,901 | ProgramServicesAmt |
| Management And General | $8,849,246 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,929,449 | TotalAmt |
| Program Services | $1,622,914 | ProgramServicesAmt |
| Management And General | $306,535 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,621,790 | TotalAmt |
| Program Services | $6,359,782 | ProgramServicesAmt |
| Management And General | $1,262,008 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,975,737 | TotalAmt |
| Program Services | $3,309,403 | ProgramServicesAmt |
| Management And General | $666,334 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,735,849 | TotalAmt |
| Program Services | $17,260,521 | ProgramServicesAmt |
| Management And General | $3,475,328 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,496 | TotalAmt |
| Program Services | $101,133 | ProgramServicesAmt |
| Management And General | $20,363 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,501 | TotalAmt |
| Program Services | $47,864 | ProgramServicesAmt |
| Management And General | $9,637 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,713,717 | TotalAmt |
| Program Services | $16,409,698 | ProgramServicesAmt |
| Management And General | $3,304,019 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,874 | TotalAmt |
| Program Services | $207,163 | ProgramServicesAmt |
| Management And General | $41,711 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,630,616 | TotalAmt |
| Program Services | $1,357,325 | ProgramServicesAmt |
| Management And General | $273,291 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,707,111 | TotalAmt |
| Program Services | $1,420,999 | ProgramServicesAmt |
| Management And General | $286,112 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,106 | TotalAmt |
| Program Services | $25,060 | ProgramServicesAmt |
| Management And General | $5,046 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,669,949 | TotalAmt |
| Program Services | $5,669,949 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,098,474 | TotalAmt |
| Program Services | $6,741,170 | ProgramServicesAmt |
| Management And General | $1,357,304 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,095,330 | TotalAmt |
| Program Services | $911,753 | ProgramServicesAmt |
| Management And General | $183,577 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $22,944,133 | $19,098,696 | $3,845,437 |
| BAD DEBT EXPENSE | $6,540,200 | $6,540,200 | |
| GOVERNMENT TAXES | $4,686,942 | $4,686,942 | |
| MAINTENANCE AND REPAIRS | $2,942,725 | $2,449,524 | $493,201 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,740,471 | TotalAmt |
| Program Services | $2,541,699 | ProgramServicesAmt |
| Management And General | $198,772 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,268,636 | TotalAmt |
| Program Services | $143,991,696 | ProgramServicesAmt |
| Management And General | $25,276,940 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,450 | BOYAmt |
| EOY | $1,450 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,331,810 | BOYAmt |
| EOY | $35,642,857 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,878,837 | BOYAmt |
| EOY | $27,266,879 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,278,244 | BOYAmt |
| EOY | $2,347,646 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $454,218 | BOYAmt |
| EOY | $729,627 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $147,708,946 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $55,426,728 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,619,155 | BOYAmt |
| EOY | $92,282,218 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,086,702 | BOYAmt |
| EOY | $11,359,494 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,607,000 | BOYAmt |
| EOY | $3,607,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,885 | BOYAmt |
| EOY | $290,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,680,301 | BOYAmt |
| EOY | $173,527,171 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,630,165 | BOYAmt |
| EOY | $15,792,661 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,264,444 | BOYAmt |
| EOY | $127,529,151 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,894,609 | BOYAmt |
| EOY | $143,321,812 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,785,692 | BOYAmt |
| EOY | $30,205,359 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,785,692 | BOYAmt |
| EOY | $30,205,359 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,680,301 | BOYAmt |
| EOY | $173,527,171 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $26,902,923 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $916,744 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$30,400,000 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,943,696 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,224,015 | DepreciationAmt |
| Book Value | $81,719,681 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,765,250 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,202,713 | DepreciationAmt |
| Book Value | $10,562,537 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $92,282,218 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MAPLE GROVE HOSPITAL EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2017 OR 2016. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 275.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,807,924 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,807,924 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02840 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,275,250 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,612,715 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,662,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03940 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,083,174 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,612,715 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,470,459 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06780 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $202,345 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $202,345 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $202,345 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $202,345 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,285,519 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,612,715 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,672,804 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06900 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,261,949 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $33,738,135 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $35,008,525 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,270,390 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | MAPLE GROVE HOSPITAL CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9875 HOSPITAL DRIVE | AddressLine1Txt |
| City | MAPLE GROVE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55369 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAPLE GROVE HOSPITAL CORPORATION | 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 | 16 | 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 | WWW.MAPLEGROVEHOSPITAL.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MAPLEGROVEHOSPITAL.ORG | 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 | 275.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MAPLEGROVEHOSPITAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.MAPLEGROVEHOSPITAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.MAPLEGROVEHOSPITAL.ORG | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| None Made | Yes (X) | NoneMadeInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MAPLE GROVE HOSPITAL CORPORATION | PART V, SECTION B, LINE 5: ONE OF THE KEY OBJECTIVES IN CONDUCTING THE 2016 CHNA WAS TO IDENTIFY HEALTH ISSUES WHICH ARE MOST IMPORTANT TO OUR COMMUNITY MEMBERS AND ESTABLISH OR STRENGTHEN COMMUNITY RELATIONSHIPS TO HELP ADDRESS THESE HEALTH ISSUES. THIS WAS ACCOMPLISHED IN SEVERAL WAYS. A STEERING COMMITTEE COMPOSED OF COMMUNITY LEADERS, SOCIAL SERVICE PROVIDERS, HEALTH CARE PROVIDERS, SCHOOL DISTRICT EMPLOYEES, BUSINESS REPRESENTATIVES AND A PUBLIC HEALTH REPRESENTATIVE GUIDED THE ASSESSMENT PROCESS AND IDENTIFICATION OF HEALTH NEEDS. MAPLE GROVE HOSPITAL CONVENED 5 FOCUS GROUPS FROM TARGET POPULATIONS THROUGHOUT THE COMMUNITY. WE FURTHER INTERVIEWED KEY STAKEHOLDERS FROM LOCAL GOVERNMENT, LAW ENFORCEMENT, EDUCATION, RELIGIOUS AND COMMUNITY-BASED ORGANIZATIONS. LASTLY WE CONDUCTED AN ONLINE SURVEY FOR BUSINESS GROUPS, THE FAITH COMMUNITY AND COMMUNITY MEMBERS. THE ASSESSMENT WAS COMPLETED WORKING IN CONJUNCTION WITH FAIRVIEW AND MAPLE GROVE HOSPITAL. |
| MAPLE GROVE HOSPITAL CORPORATION | PART V, SECTION B, LINE 11: OUR MOST RECENT CHNA WAS CONDUCTED IN 2016. THE OVERALL CHNA WAS GUIDED BY THE COMMUNITY ENGAGEMENT ADVISORY TEAM WHICH IS COMPOSED OF COMMUNITY MEMBERS, MAPLE GROVE HOSPITAL EMPLOYEES, AND PUBLIC HEALTH REPRESENTATIVES. DATA USED TO IDENTIFY THE TOP PRIORITIES INCLUDED: DEMOGRAPHIC DATA; QUANTITATIVE DATA FROM THE MINNESOTA HOSPITAL ASSOCIATION, MINNESOTA DEPARTMENT OF HEALTH, HENNEPIN COUNTY SHAPE 2014, COMMUNITY NEED INDEX AND ATTRIBUTED PATIENT DATA; QUALITATIVE DATA FROM FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS, AND COMMUNITY ASSET MAPPING. THE FOLLOWING PRIORITIES WERE IDENTIFIED IN THE ASSESSMENT:-MENTAL HEALTH/SUBSTANCE ABUSE/USE-HEALTHY AGING/SENIOR SERVICES-CANCER PREVENTION, SCREENING, HEALTHY SURVIVORS-INJURY PREVENTION ACROSS THE LIFESPAN-NUTRITION/HEALTHY LIFESTYLES-YOUTH ENGAGEMENT EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT-UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES-TRANSPORTATION/HEALTHCARE ACCESSAFTER DISCUSSION OF THE HEALTH PRIORITIES, THE COMMUNITY ENGAGEMENT ADVISORY TEAM VOTED TO FOCUS ON TWO HEALTH PRIORITIES. PRIORITIZATION WAS BASED ON THE FOLLOWING CRITERIA:-HOW WIDESPREAD IS THE HEALTH NEED?-HOW SERIOUS OR IMPORTANT DO YOU THINK THIS HEALTH NEED IS FOR INDIVIDUALS AND/OR THE COMMUNITY?-WHAT IS THE POTENTIAL FOR MAPLE GROVE HOSPITAL AND COMMUNITY PARTNERS TO HAVE A POSITIVE IMPACT ON THIS HEALTH NEED WITHIN 3 TO 4 YEARS?BASED ON THESE CRITERIA, THE TOP NEEDS WERE IDENTIFIED AS:-MENTAL HEALTH/SUBSTANCE ABUSE/USE: 207 VOTES-HEALTHY AGING/SENIOR SERVICES: 169 VOTES-CANCER - PREVENTION, SCREENING, HEALTHY SURVIVORS: 162 VOTES-NUTRITION/HEALTHY LIFESTYLES: 161 VOTES-INJURY PREVENTION ACROSS THE LIFESPAN: 159 VOTES-UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES: 157 VOTES-YOUTH ENGAGEMENT EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT: 143 VOTES-TRANSPORTATION/HEALTHCARE ACCESS: 132 VOTESAFTER A REVIEW OF POTENTIAL IMPLEMENTATION PROJECTS TO ADDRESS THESE HEALTH PRIORITIES, A DECISION WAS MADE TO SEPARATE MENTAL HEALTH AND SUBSTANCE ABUSE/USE. THE FINAL HEALTH PRIORITIES FROM THE 2016 CHNA ARE:-MENTAL HEALTH-SUBSTANCE ABUSE/USE AND-HEALTHY AGING/SENIOR SERVICESTHESE HEALTH PRIORITIES ARE BEING ADDRESSED WITH COMMUNITY PARTNERSHIPS, COMMUNITY SUPPORT AND CULTURAL APPROPRIATENESS IN MIND. MAPLE GROVE HOSPITAL IS USING SEVERAL STRATEGIES TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES. PRIORITY 1: MENTAL HEALTH (SYSTEM-WIDE PRIORITY)GOAL - TO SUPPORT THE MENTAL HEALTH OF COMMUNITY MEMBERS ALONG THE MENTAL HEALTH CONTINUUM.OBJECTIVES:I. REDUCE THE STIGMA ASSOCIATED WITH MENTAL HEALTH CONDITIONS STRATEGIES:-INCORPORATED THE "MAKE IT OK" MESSAGE INTO ANNUAL EMPLOYEE TRAINING-ACTION - THE "MAKE IT OK" MESSAGE HAS BEEN INCLUDED IN THE ANNUAL ALL EMPLOYEE TRAINING.-INCORPORATE THE "MAKE IT OK" MESSAGE ON THE MAPLE GROVE HOSPITAL WEBSITE AND IN OUR PUBLIC COMMUNICATIONS DURING MAY - MENTAL HEALTH AWARENESS MONTH-ACTION - USED OUR WEBSITE TO SHARE INFORMATION ABOUT A MAY 18, 2017 YOUTH MENTAL HEALTH FIRST AID CLASS WITH THE COMMUNITY. INCORPORATING ADDITIONAL INFORMATION ON "MAKE IT OK" ON THE WEBSITE HAS BEEN DEFERRED TO 2018. II. INCREASE EDUCATION ABOUT MENTAL HEALTH STRATEGIES:-OFFER A MINIMUM OF FOUR EVIDENCE BASED MENTAL HEALTH FIRST AID (MHFA) CLASSES ACROSS THE SYSTEM ANNUALLY-ACTION - THREE MENTAL HEALTH FIRST AID CLASSES WERE OFFERED TO THE COMMUNITY IN 2017. THESE INCLUDE: -MAY 18, 2017 YOUTH-FOCUSED MHFA CLASS AT MAPLE GROVE HOSPITAL 19 PERSONS ATTENDED. -AUGUST 1, 2017 YOUTH-FOCUSED MHFA CLASS AT WAYZATA SCHOOL DISTRICT 25 PERSONS ATTENDED. -DECEMBER 1, 2017 ADULT-FOCUSED MHFA CLASS AT NORTH MEMORIAL HEALTH OUTPATIENT CENTER 22 PERSONS ATTENDED.-ACTION - INSTEAD OF OFFERING A FOURTH MENTAL HEALTH FIRST AID CLASS IN 2017 WE PARTNERED WITH OTHER HEALTHCARE ORGANIZATIONS TO FINANCIALLY SUPPORT THE TRAINING OF ADDITIONAL YOUTH MENTAL HEALTH FIRST AID INSTRUCTORS. III. IMPROVE ACCESS TO MENTAL HEALTH SERVICES STRATEGIES:-OPENED THE NORTH MEMORIAL HEALTH MENTAL HEALTH & ADDICTION CARE CLINIC (THE NAME CHANGED TO MENTAL HEALTH CLINIC IN 2018)-ACTION - THE CLINIC LOCATED IN ROBBINSDALE OPENED IN DECEMBER 2016 IN RESPONSE TO AN IDENTIFIED COMMUNITY NEED. THE CLINIC HAS 10,300 SQ. FT. AND FOCUSES ON GENERAL MENTAL HEALTH PROBLEMS WITH A SPECIFIC FOCUS ON SERIOUS AND PERSISTENT MENTAL ILLNESS AND POST-TRAUMATIC STRESS DISORDER.-CONTINUED ASSESSMENT OF COMMUNITY NEED AND DEVELOPMENT OF PROGRAMS AS NEED IS IDENTIFIED-ACTION - NORTH MEMORIAL HEALTH CURRENTLY HAS EMERGENCY MEDICINE, A CONSULT SERVICE FOR THE ED, OBSERVATION AND MEDICAL UNITS, AN INPATIENT PSYCHIATRIC UNIT, TWO TRACKS OF PARTIAL HOSPITAL PROGRAMS, TWO TRACKS OF INTENSIVE OUTPATIENT PROGRAMS, OUTPATIENT THERAPY AND PSYCHIATRY AND 3 INTEGRATED BEHAVIORAL HEALTH PROVIDERS IN 4 OF ITS 15 PRIMARY CLINICS. THE CUSTOMER BASE RANGES IN AGES OF 18 TO 90, COMES FROM VARIED ETHNIC BACKGROUNDS WITH A VARIETY OF INSURERS INCLUDING THIRD PARTY PAYERS, MEDICARE AND MEDICAID. MOST OF OUR CUSTOMERS HAVE DIAGNOSES OF PSYCHOSIS, PTSD, AND MOOD DISORDERS. IV. SUPPORT NORTH MEMORIAL HEALTH'S DOMESTIC VIOLENCE ADVOCACY PROGRAM SAFEJOURNEYSTRATEGIES:-ENSURE 24 HOUR ADVOCACY IS PROVIDED BY TRAINED VOLUNTEERS-ACTION - 24 HOUR ADVOCACY IS IN PLACE.-TRAIN 25 TO 30 NEW VOLUNTEERS IN 2017-ACTION - ONE SYSTEM WIDE VOLUNTEER TRAINING WAS HELD IN 2017. VOLUNTEERS SERVE BOTH MAPLE GROVE HOSPITAL AND NORTH MEMORIAL HEALTH HOSPITAL. 23 VOLUNTEER ADVOCATES WERE TRAINED.-INCREASE THE NUMBER OF PARTICIPANTS AT MAPLE GROVE HOSPITAL-ACTION - A TOTAL OF 128 CLIENTS WERE SERVED AT MAPLE GROVE HOSPITAL IN 2017. THERE WERE 152 ENCOUNTERS AT MAPLE GROVE HOSPITAL WHICH INCLUDES DUPLICATE CLIENTS. THERE ARE ALSO 182 CLIENT ENCOUNTERS THAT DO NOT FIT UNDER A HOSPITAL. THESE INCLUDE 169 PHONE CALLS, 6 WALK-INS, AND 7 CLINIC VISITS.-TRAIN NEW FACILITATORS FOR SUPPORT GROUPS-ACTION - NO NEED FOR NEW SUPPORT GROUP FACILITATORS WAS IDENTIFIED AT MAPLE GROVE HOSPITAL IN 2017.-DISTRIBUTE CLIENT EMERGENCY FUNDS TO QUALIFIED CLIENTS-ACTION - SYSTEM-WIDE WE SERVED 23 CLIENTS AND DISTRIBUTED $6,030.50.-PROVIDE COMMUNITY OUTREACH AND EDUCATION ON SAFEJOURNEY-ACTION - NO COMMUNITY OUTREACH AND EDUCATION WAS PROVIDED IN THE MAPLE GROVE HOSPITAL SERVICE AREA. V. WORK WITH COMMUNITY PARTNERS TO COLLECTIVELY IDENTIFY OPPORTUNITIES TO ADDRESS MENTAL HEALTH ISSUES AND SOCIAL CONDITIONS THAT AFFECT MENTAL HEALTH CONDITIONS - CHIP, CCH, WEST METRO HOSPITAL GROUP, LOCAL PUBLIC HEALTH, GOVERNMENT AND OTHERS.STRATEGIES:-CONTINUE ACTIVE INVOLVEMENT IN HENNEPIN COUNTY CHIP AND SOCIAL ISOLATION WORKGROUP-ACTION - CHIP 1.0 ENDED IN 2017. 5 SOCIAL ISOLATION EVENTS WERE HELD IN 2017.-CONTINUE ACTIVE INVOLVEMENT WITH THE CENTER FOR COMMUNITY HEALTH COLLECTIVE ACTION GROUP-ACTION - GROUP CONTINUES TO WORK ON INCREASING AWARENESS OF MENTAL HEALTH FIRST AID CLASSES IN THE METRO COMMUNITY. MAY MENTAL HEALTH AWARENESS MONTH IS A FOCUS FOR GETTING THE WORD OUT ON "MAKE IT OK AND CLASSES FOCUSED ON MENTAL HEALTH. COMMUNITY HEALTH OUTREACH MANAGER CONTINUES TO REPRESENT THE SYSTEM AT MONTHLY MEETINGS.-EXPLORE COMMUNITY PARTNERSHIP OPPORTUNITIES THAT ADDRESS MENTAL HEALTH AND VIOLENCE-ACTION - EXPLORING A COMMUNITY ZERO SUICIDE FOR YOUTH PROJECT WITH COMMUNITY PARTNERS AND MDH. |
| PART V, SECTION B, LINE 11 CONTINUED: | PRIORITY 2: SUBSTANCE ABUSE/USE (SYSTEM-WIDE PRIORITY)GOAL - TO CREATE AN ENVIRONMENT WHERE SUBSTANCE ABUSE/USE AMONG THE GENERAL POPULATION AND SUBSTANCE ABUSE/USE AMONG YOUTH IS REDUCED. OBJECTIVES:I. INCREASE AWARENESS OF SUBSTANCE ABUSE/USE ISSUES AMONG YOUTH AND YOUNG ADULTS AND ACTIVITIES TO ADDRESS THESE ISSUES STRATEGIES:-CONTINUE WORKING WITH AND SUPPORTING COMMUNITY COLLABORATIVES SUCH AS PARTNERSHIP FOR CHANGE AND PARTNERS IN PREVENTION-ACTION - ATTEND PARTNERSHIP FOR CHANGE AND PARTNERS IN PREVENTION MEETINGS.-ACTION - FINANCIALLY SUPPORT PARTNERS IN PREVENTION'S UNCOVER THE TRUTH CAMPAIGN WHICH EDUCATES WAYZATA HIGH SCHOOL STUDENTS ABOUT DRUG AND ALCOHOL ISSUES WITH REGARD TO THEIR PEERS.-ACTION - PARTNERSHIP FOR CHANGE, HOUSED OUT OF NORTH MEMORIAL HEALTH HOSPITAL'S TRAUMA DEPARTMENT, LEVERAGES COMMUNITY PARTNERSHIPS TO PREVENT AND REDUCE SUBSTANCE ABUSE IN THE COMMUNITY THROUGH STRATEGIES SUCH AS: -POLD (PLACE OF LAST DRINK) AND RAVE (RESPONSIBLE VENDOR EDUCATION & ENFORCEMENT) -EXPANDED SOCIAL HOST ORDINANCE -MEDICINE ABUSE PREVENTION WORKGROUP WHICH INCLUDES MEDICATION DROP BOXES -MARIJUANA PERCEPTION OF HARM-INCREASE COLLABORATION WITH THE NORTHWEST AND WAYZATA FAMILY SERVICE COLLABORATIVES TO ADDRESS FACTORS THAT INCREASE THE RISK OF SUBSTANCE ABUSE/USE AMONG YOUTH.-ACTION - EXPLORING A COMMUNITY ZERO SUICIDE FOR YOUTH PROJECT WITH COMMUNITY PARTNERS SUCH AS THE FAMILY SERVICE COLLABORATIVES AND MDH. II. IMPROVE ACCESS TO ADDICTION MEDICINE SERVICES STRATEGIES:-OPENED THE NORTH MEMORIAL HEALTH MENTAL HEALTH & ADDICTION CARE CLINIC (THE NAME CHANGED TO MENTAL HEALTH CLINIC IN 2018)-ACTION - THE CLINIC LOCATED IN ROBBINSDALE OPENED IN DECEMBER 2016 IN RESPONSE TO AN IDENTIFIED COMMUNITY NEED. THE CLINIC HAS 10,300 SQ. FT. AND FOCUSES ON GENERAL MENTAL HEALTH PROBLEMS WITH A SPECIFIC FOCUS ON SERIOUS AND PERSISTENT MENTAL ILLNESS AND POST-TRAUMATIC STRESS DISORDER. ORIGINALLY THE CLINIC INCLUDED ADDITION MEDICINE, HOWEVER WHEN OUR ONLY ADDITION MEDICINE PROVIDER LEFT IN EARLY 2017 A REPLACEMENT WAS NOT OBTAINED. SUBSTANCE USE DISORDERS ARE ADDRESSED WITHIN THE CONTEXT OF MENTAL HEALTH CARE, BUT WE NO LONGER PROVIDED ADDICTION SPECIFIC TREATMENT WITHIN THE MENTAL HEALTH CLINIC. -CONTINUED ASSESSMENT OF COMMUNITY NEED AND DEVELOPMENT OF PROGRAMS AS NEED IS IDENTIFIED-ACTION - NORTH MEMORIAL HEALTH CURRENTLY HAS EMERGENCY MEDICINE, A CONSULT SERVICE FOR THE ED, OBSERVATION AND MEDICAL UNITS, AN INPATIENT PSYCHIATRIC UNIT, TWO TRACKS OF PARTIAL HOSPITAL PROGRAMS, TWO TRACKS OF INTENSIVE OUTPATIENT PROGRAMS, OUTPATIENT THERAPY AND PSYCHIATRY AND 3 INTEGRATED BEHAVIORAL HEALTH PROVIDERS IN 4 OF ITS 15 PRIMARY CLINICS. THE CUSTOMER BASE RANGES IN AGE FROM 18 TO 90, COMES FROM VARIED ETHNIC BACKGROUNDS WITH A VARIETY OF INSURERS INCLUDING THIRD PARTY PAYERS, MEDICARE AND MEDICAID. MOST OF OUR CUSTOMERS HAVE DIAGNOSES OF PSYCHOSIS, PTSD, AND MOOD DISORDERS. III. INCREASE AWARENESS OF OPIOID MISUSE AND WORK TO PUT SYSTEMS IN PLACE TO REDUCE THIS MISUSESTRATEGIES:-WORK WITH ICSI (INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT) ON PROGRAM DEVELOPMENT-ACTION - WORKGROUPS HAVE BEEN FORMED AROUND: -ACUTE PRESCRIBING -CHRONIC PRESCRIBING FOR CHRONIC PAIN -HIGH RISK POPULATIONS -PROPER DISPOSAL OF UNUSED OPIOIDS.-CONTINUE INVOLVEMENT WITH PARTNERSHIP FOR CHANGE AND MINNESOTA'S PRESCRIPTION MONITORING PROGRAM (PMP)-ACTION - PARTNERSHIP FOR CHANGE WORKED IN PARTNERSHIP WITH THE PHARMACY DEPARTMENT ON INTEGRATING PMP INTO EPIC, PATIENT PORTAL.-RESEARCH COMMUNITY BASED OPIOID ABUSE PREVENTION PROGRAMS-ACTION - BEING ADDRESSED BY WORK WITH ICSI AND PARTNERSHIP FOR CHANGE.PRIORITY 3: HEALTHY AGING/SENIOR SERVICESGOAL - TO WORK TOGETHER WITH LOCAL GOVERNMENT, OTHER HEALTHCARE SYSTEMS, SOCIAL SERVICE PROVIDERS AND COMMUNITY MEMBERS TO CREATE AN ENVIRONMENT WHERE OUR AGING POPULATION CAN HAVE ACCESS TO THE PROGRAMS AND SERVICES NEEDED TO AGE IN PLACE.OBJECTIVES:I. ADDRESS COMMUNITY-BASED INFRASTRUCTURE CHALLENGES THAT CREATE BARRIERS TO HEALTHY AGING IN MAPLE GROVESTRATEGIES:-CONTINUE WORKING WITH THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE INITIATIVE -ACTION - ACTIVE PARTICIPATION ON THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE INITIATIVE.II. IMPROVE EDUCATION ABOUT ADVANCE CARE PLANNING STRATEGIES:-OFFER A MINIMUM OF FOUR EVIDENCE BASED RESPECTING CHOICES PRESENTATION IN THE MAPLE GROVE COMMUNITY ASSESSMENT AREA-ACTION - TWO CLASSES WERE OFFERED IN THE MAPLE GROVE ASSESSMENT AREA IN 2017: -TRADITION INDEPENDENT AND ASSISTED LIVING BROOKLYN PARK MN. 25 PARTICIPANTS -PLYMOUTH HEALTHY LIVING FAIR PLYMOUTH MN. 30 PARTICIPANTS -OTHER CLASSES WERE NOT OFFERED DURING 2017 BECAUSE THE ADVANCE CARE PLANNING COORDINATOR LEFT HER POSITION AND WAS NOT REPLACED.-EXPLORE OFFERING A RESPECTING CHOICES TRAIN THE PRESENTER SESSION TO COMMUNITY PARTNERS THAT WOULD OFFER THE RESPECTING CHOICES CLASS TO THE WIDER COMMUNITY-ACTION - DEFERRED UNTIL NEW ADVANCE CARE PLANNING COORDINATOR IS IN PLACE. III. EXPLORE IMPLEMENTING A COMMUNITY BASED FALLS PREVENTION EDUCATION PROGRAM STRATEGIES:-LOOK INTO IMPLEMENTING THE STEPPING ON AND/OR MATTER OF BALANCE PROGRAMS-ACTION - TWO STAFF MEMBERS ATTENDED THE FALL PREVENTION STEPPING ON FACILITATOR TRAINING IN MAY 2017. THE FIRST STEPPING ON CLASS WAS OFFERED AT THE MAPLE GROVE COMMUNITY CENTER IN THE FOURTH QUARTER OF 2017. A 11 PEOPLE COMPLETED THE COURSE.IV. COMMIT MAPLE GROVE HOSPITAL SUPPORT AND RESOURCES TO WORK WITH COMMUNITY PARTNERS TO COLLECTIVELY IDENTIFY OPPORTUNITIES TO ADDRESS ISSUES AND CONDITIONS THAT AFFECT HEALTH AGINGSTRATEGIES:-OFFER FINANCIAL SUPPORT FOR THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE INITIATIVE-ACTION - FINANCIAL SUPPORT WAS PROVIDED TO THE CITY OF MAPLE GROVE'S AGE-FRIENDLY INITIATIVE TO SUPPORT THE CONSULTANT HIRED TO ADVANCE THIS WORK.V. WORK WITH COMMUNITY PARTNERS TO REDUCE CONDITIONS THAT NEGATIVELY AFFECT THE MENTAL HEALTH OF SENIORS SUCH AS SOCIAL ISOLATIONSTRATEGIES:-CONTINUE WORKING WITH HENNEPIN COUNTY CHIP SOCIAL ISOLATION COMMITTEE-ACTION - CHIP 1.0 ENDED IN 2017. 5 SOCIAL ISOLATION EVENTS WERE HELD IN 2017.-EXPLORE POTENTIAL PARTNERSHIPS WITH SOCIAL SERVICE GROUPS THAT ADDRESS SOCIAL ISOLATION-ACTION - IN 2017 NORTH MEMORIAL HEALTH COMMUNITY PARAMEDICS CONDUCTED 2,904 IN-HOME ENCOUNTERS. 271 OF THESE HOME ENCOUNTERS WERE IN THE MAPLE GROVE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT AREA. SOCIAL ISOLATION AND FOOD SECURITY ARE ADDRESSED AT EVERY VISIT. THE HEALTH PRIORITIES NOT BEING ADDRESSED DIRECTLY INCLUDE:-CANCER - PREVENTION, SCREENING, HEALTHY SURVIVORS -NUTRITION/HEALTHY LIFESTYLES -INJURY PREVENTION ACROSS THE LIFESPAN -UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES-YOUTH ENGAGEMENT - EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT-TRANSPORTATION/HEALTHCARE ACCESS THE COMMUNITY ENGAGEMENT ADVISORY TEAM FELT THAT TO MAKE A MEANINGFUL DIFFERENCE IN THE TOP THREE IDENTIFIED HEALTH PRIORITIES RESOURCES SHOULD BE FOCUSED ON THESE PRIORITIES AND NOT SPREAD ACROSS A MULTITUDE OF PRIORITIES. CANCER PREVENTION, SCREENING AND HEALTHY SURVIVORS IS BEING ADDRESSED BY THE AMERICAN CANCER SOCIETY AND THE CANCER CENTER AT NORTH MEMORIAL HEALTH HOSPITAL. NUTRITION AND HEALTHY LIFESTYLES IS BEING ADDRESSED BY MANY GROUPS SUCH AS THE AMERICAN CANCER SOCIETY, THE AMERICAN HEART ASSOCIATION, THE YMCA AND LOCAL PARK AND RECREATION ASSOCIATIONS. INJURY PREVENTION IS BEING ADDRESSED BY SAFE KIDS OUT OF NORTH MEMORIAL HEALTH AND SENIOR INJURY PREVENTION IS BEING ADDRESSED THROUGH THE HEALTHY AGING/SENIOR SERVICES HEALTH PRIORITY. CULTURAL DIVERSITY IS BEING WOVEN INTO THE TOP THREE PRIORITIES. YOUTH HAVE ACCESS TO VOLUNTEER OPPORTUNITIES THROUGH MAPLE GROVE HOSPITAL'S VOLUNTEER DEPARTMENT. TRANSPORTATION IS BEING DISCUSSED AT THE COUNTY AND LOCAL LEVEL ALONG WITH THE HEALTHY AGING/SENIOR SERVICES PRIORITY. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2: | AMOUNT REPRESENTS THE HOSPITAL'S BAD DEBT PROVISION REDUCED BY THE HOSPITAL'S COST TO CHARGE RATIO WHICH REPRESENTS THE BEST ESTIMATE OF COST FOR THE BAD DEBT PROVISION. |
| PART III, LINE 4: | MAPLE GROVE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIPTION ABOUT BAD DEBT EXPENSE. THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT ON PART III, SECTION A, LINE 2. WE DO NOT HAVE THE INFORMATION NECESSARY TO DETERMINE WHICH PORTION OF THE AMOUNT REPORTED ON LINE 2 IS COMMUNITY BENEFIT. |
| PART III, LINE 8: | THE SHORTFALL REPORTED REPRESENTS THE AMOUNT THE MEDICARE REIMBURSEMENT IS LESS THAN THE ESTIMATED COST OF PROVIDING SERVICES TO THOSE PATIENTS. THE METHOD USED TO ESTIMATE THOSE COSTS IS THE COST TO CHARGE RATIO APPROACH WHICH CALCULATES THE RATIO OF TOTAL HOSPITAL COSTS / TOTAL HOSPITAL GROSS REVENUE AND THEM APPLIES THAT RATIO TO TOTAL MEDICARE GROSS REVENUE. |
| PART III, LINE 9B: | MAPLE GROVE HOSPITAL CORPORATION HAS POLICIES AND PROCEDURES IN PLACE FOR COLLECTION PRACTICES THAT INCLUDE IDENTIFICATION AND SCREENING FOR CHARITY CARE AND FINANCIAL ASSISTANCE. THE POLICIES ARE AVAILABLE ON THE ORGANIZATION'S INTRANET AND EACH PATIENT IS GIVEN A BROCHURE UPON ADMISSION. |
| PART VI, LINE 2: | MAPLE GROVE HOSPITAL WORKS CLOSELY WITH COMMUNITY MEMBERS TO DETERMINE AREAS OF INTEREST AND NEED IN HEALTHCARE SERVICES. (A NEW COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2016. WE ARE CURRENTLY ADDRESSING THE NEEDS IDENTIFIED IN OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT.) |
| PART VI, LINE 3: | MAPLE GROVE HOSPITAL HAS A VERY PROACTIVE PROGRAM TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH THEIR MEDICAL BILLS. WE COMPLY WITH THE ATTORNEY GENERAL'S REQUIREMENT TO PROVIDE A DISCOUNT TO UNINSURED MINNESOTA RESIDENTS AS WELL AS A FINANCIAL ASSISTANCE PROGRAM FOR FINANCIALLY QUALIFIED PATIENTS. WE HAVE PATIENT FINANCIAL ADVOCATES AS WELL AS A CONTRACTED VENDOR THAT MEETS WITH ALL OF OUR UNINSURED INPATIENTS AND SPECIFIC OUTPATIENTS TO ASSIST THEM IN MEDICAL ASSISTANCE ELIGIBILITY AND APPLICATIONS. THIS COULD INCLUDE A VISIT TO THEIR RESIDENCE IF THEY NEED HELP IN COMPLETING ASSISTANCE APPLICATIONS. SHOULD THEY NOT QUALIFY FOR STATE OR FEDERAL ASSISTANCE PROGRAMS, WE OFFER AND ASSIST THEM IN APPLYING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM.IN ADDITION, OUR INTERNAL COLLECTIONS DEPARTMENT AND OUR COLLECTION AGENCIES ARE WELL VERSED IN OUR ASSISTANCE PROGRAMS AND WILL ASSESS DURING THEIR CONVERSATIONS WITH PATIENTS IF REFERRAL TO EITHER A STATE OR FEDERAL PROGRAM OR OUR CHARITY CARE PROGRAM WOULD BE APPROPRIATE. MAPLE GROVE HOSPITAL IDENTIFIED MINOR OMISSIONS AND ERRORS RELATED TO 501(R) CHARITY CARE PRACTICES DURING TAX YEAR 2016 THAT IMPACTED BOTH 2016 AND 2017, AND WERE DUE TO REASONABLE CAUSE. PRIOR TO THE IMPLEMENTATION OF 501(R), MAPLE GROVE HOSPITAL WAS SUBJECT TO MINNESOTA ATTORNEY GENERAL REQUIREMENTS. THE OMISSIONS AND ERRORS OCCURRED WHEN INTEGRATING 501(R) REQUIREMENTS WITH MINNESOTA ATTORNEY GENERAL REQUIREMENTS. UPON DISCOVERY OF THE OMISSIONS, MAPLE GROVE HOSPITAL POLICIES AND PROCEDURES WERE PROMPTLY REVISED TO PROMOTE AND FACILITATE OVERALL COMPLIANCE WITH BOTH FEDERAL AND STATE REQUIREMENTS. THE REVISED 501(R) POLICY AND PROCEDURES WERE EFFECTIVE 07/17/2017. |
| PART VI, LINE 4: | WE SERVE A 27 ZIP-CODE AREA IN THE NORTHWEST SIDE OF THE TWIN CITIES METRO. THIS IS BASED ON THE HOME ZIP CODES FOR 75% OF OUR INPATIENT POPULATION, EXCLUDING NEWBORNS AND NEONATES. WE WORK WITH THE COMMUNITY TO ADDRESS COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. |
| PART VI, LINE 5: | MAPLE GROVE HOSPITAL PROVIDES EDUCATIONAL RESOURCES FOR COMMUNITY MEMBERS SUCH AS CLASSES ON HEALTH CARE DIRECTIVES, KIDS SAFETY FAIRS AND SEMINARS ON HEALTH TOPICS. |
| PART VI, LINE 6: | MAPLE GROVE HOSPITAL IS A PART OF NORTH MEMORIAL HEALTH SYSTEM, WHICH IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THROUGH TARGETED OUTREACH, EDUCATION AND PARTNERSHIPS, WE IMPROVE THE HEALTH OF OUR COMMUNITIES BY LISTENING TO THEIR NEEDS AND RESPONDING WITH APPROPRIATE PROGRAMS AND SERVICES. OUR PROGRAMS, MANY OF WHICH HAVE BEEN NATIONALLY RECOGNIZED, RANGE FROM HEALTH EDUCATION AND FREE SCREENING TO TRAINING HEALTH PROFESSIONALS. |
| PART VI, LINE 7: | MAPLE GROVE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF MINNESOTA. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J KEVIN CROSTON MD | ||||||||||||||
| BOARD CHAIR | $0 | $765,410 | $0 | $191,639 | $0 | $8,732 | $0 | $18,900 | $0 | $27,507 | $0 | $1,012,188 | $0 | $0 |
| AARON BLOOMQUIST | ||||||||||||||
| TREASURER | $0 | $380,560 | $0 | $57,321 | $0 | $30,908 | $0 | $18,900 | $0 | $13,965 | $0 | $501,654 | $0 | $0 |
| ANDREW HOULTON MD | ||||||||||||||
| DIRECTOR - PART YEAR | $0 | $412,508 | $0 | $63,000 | $0 | $7,766 | $0 | $18,900 | $0 | $17,462 | $0 | $519,636 | $0 | $0 |
| JENNIFER CLOSE | ||||||||||||||
| DIRECTOR | $0 | $420,000 | $0 | $0 | $0 | $3,351 | $0 | $11,769 | $0 | $17,212 | $0 | $452,332 | $0 | $0 |
| JEFF WICKLANDER | ||||||||||||||
| DIRECTOR | $0 | $419,343 | $0 | $63,045 | $0 | $2,315 | $0 | $18,900 | $0 | $26,738 | $0 | $530,341 | $0 | $0 |
| ANDREW COCHRANE | ||||||||||||||
| PRESIDENT | $0 | $350,000 | $0 | $87,500 | $0 | $3,071 | $0 | $18,900 | $0 | $24,889 | $0 | $484,360 | $0 | $0 |
| PAMELA DOORENBOS MD | ||||||||||||||
| VP MEDICAL AFFAIRS | $299,757 | $0 | $59,575 | $0 | $661 | $0 | $10,911 | $0 | $9,181 | $0 | $380,085 | $0 | $0 | $0 |
| STEVEN HORSTMANN | ||||||||||||||
| VP OPERATIONS | $132,312 | $66,981 | $26,701 | $0 | $98 | $200 | $4,437 | $2,481 | $979 | $1,530 | $164,527 | $71,192 | $0 | $0 |
| WENDY ULFERTS | ||||||||||||||
| VP PATIENT CARE/ CHIEF NURSING OFFIC | $113,894 | $0 | $26,084 | $0 | $1,200 | $0 | $4,884 | $0 | $8,345 | $0 | $154,407 | $0 | $0 | $0 |
| KAREN HALL | ||||||||||||||
| PHARMACIST | $165,994 | $0 | $18,467 | $0 | $655 | $0 | $9,223 | $0 | $16,277 | $0 | $210,616 | $0 | $0 | $0 |
| SARAH R JOHNSON | ||||||||||||||
| MANAGER, PHARMACY | $153,002 | $0 | $13,328 | $0 | $2,178 | $0 | $8,317 | $0 | $16,218 | $0 | $193,043 | $0 | $0 | $0 |
| REBECCA THIESFELD RAUEN | ||||||||||||||
| DIRECTOR, HUMAN RESOURCES | $142,349 | $0 | $25,740 | $0 | $959 | $0 | $8,405 | $0 | $17,174 | $0 | $194,627 | $0 | $0 | $0 |
| LEAH WANDERSEE | ||||||||||||||
| DIRECTOR, PROCEDURAL CARE | $148,582 | $0 | $25,958 | $0 | $1,437 | $0 | $8,727 | $0 | $8,050 | $0 | $192,754 | $0 | $0 | $0 |
| FAITH ZWIRCHITZ | ||||||||||||||
| DIRECTOR, WOMENS & CHILDREN'S | $148,456 | $0 | $25,939 | $0 | $102 | $0 | $8,720 | $0 | $1,993 | $0 | $185,210 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CHIEF EXECUTIVE OFFICER IS AN EMPLOYEE OF NORTH MEMORIAL HEALTH CARE. OTHER BOARD MEMBERS LISTED WITH COMPENSATION FROM A RELATED ORGANIZATION ARE OFFICERS AND KEY EMPLOYEES OF NORTH MEMORIAL HEALTH CARE WHO PROVIDE SERVICES TO MAPLE GROVE HOSPITAL AS WELL AS TO ALL OR SOME RELATED ENTITIES AS IDENTIFIED ON SCHEDULE R. AS SUCH, THEIR COMPENSATION LEVELS INCORPORATE SERVICES PROVIDED TO MULTIPLE NORTH MEMORIAL ENTITIES. |
| PART I, LINE 6 | NORTH MEMORIAL HEALTH CARE'S ANNUAL INCENTIVE PLAN REQUIRES ACHIEVEMENT OF STATED PERFORMANCE METRICS, WHICH INCLUDE OPERATING CASH FLOW MARGIN. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF MAPLE GROVE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 410873250 | BondIssuerEIN |
| CUSIP | 56516TBU8 | CUSIPNum |
| Bond Issued | 2017-05-25 | BondIssuedDt |
| Issue Price | $128,801,633 | IssuePriceAmt |
| Purpose | REFUNDING OF 2007 BOND SERIES | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | Yes (1) | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $128,801,633 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $1,020,988 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $127,780,645 | OtherSpentProceedsAmt |
| Substantial Completion | 2017 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | NORTH MEMORIAL HEALTH CARE, A RELATED PARTY, PERFORMS MANAGEMENT DUTIES ON BEHALF OF MAPLE GROVE HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 6 | MAPLE GROVE HOSPITAL HAS ONE CLASS OF MEMBERS. NORTH MEMORIAL HEALTH CARE ("NORTH MEMORIAL") AND FAIRVIEW HEALTH SERVICES ("FAIRVIEW") ARE THE ONLY MEMBERS OF THE CORPORATION AND BOTH MEMBERS ARE NONPROFIT, TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS IS COMPRISED OF SEVEN VOTING DIRECTORS AND ONE NON-VOTING DIRECTOR, AS FOLLOWS: (A) THE CHIEF EXECUTIVE OFFICER OF NORTH MEMORIAL AND FOUR OTHER DIRECTORS APPOINTED ANNUALLY BY NORTH MEMORIAL (B) THE CHIEF EXECUTIVE OFFICER OF FAIRVIEW AND ONE OTHER DIRECTOR APPOINTED ANNUALLY BY FAIRVIEW AND (C) THE MAPLE GROVE HOSPITAL CHIEF EXECUTIVE OFFICER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBERS, AND ONLY THE MEMBERS, MAY TAKE DIRECT ACTION ON THE FOLLOWING MATTERS BY UNANIMOUS MEMBER APPROVAL: (A) AMENDMENTS TO THE ARTICLES OF INCORPORATION; (B) AMENDMENTS TO THE BYLAWS; (C) MERGER OR CONSOLIDATION OF THE CORPORATION (D) SALE, LEASE OR TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (E) JOINT VENTURES AFFECTING SUBSTANTIALLY ALL OF THE ASSETS OR OPERATIONS OF THE CORPORATION; (F) DETERMINATION OF THE NAME UNDER WHICH THE HOSPITAL CONDUCTS BUSINESS; (G) CERTAIN MORTGAGES OR OTHER SECURITY INTERESTS; (H) ISSUANCE OF CAPITAL CALLS; AND (I) DISSOLUTION AND LIQUIDATION OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE MANAGEMENT COMPANY AND THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE IT IS FILED. REPRESENTATIVES FROM THE HOSPITAL'S INDEPENDENT ACCOUNTING FIRM REVIEW THE FORM 990 WITH THE MANAGEMENT COMPANY IN DETAIL AND NOTES FOR THE COMMITTEE ANY CHANGES IN THE FORM 990 FROM PRIOR YEARS. AFTER THOROUGH DISCUSSION, THE MANAGEMENT COMPANY APPROVES THE FORM 990 AND FORWARDS IT TO THE BOARD FOR ITS REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL EMPLOYEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY EACH YEAR. EACH BOARD MEMBER AND STAFF MEMBER FILLS OUT A CONFLICT OF INTEREST QUESTIONNAIRE IN WHICH THEY ARE ASKED TO IDENTIFY ANY RELATIONSHIP THAT WOULD CREATE A CONFLICT OF INTEREST. THE RESULTS ARE SUMMARIZED AND REVIEWED TO DETERMINE ANY ACTUAL OR POTENTIAL CONFLICT AND ARE REPORTED TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR KEY POSITIONS ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF NORTH MEMORIAL WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE EXECUTIVE COMMITTEE OF NORTH MEMORIAL INSURES THAT THE SALARY AND BENEFIT ADMINISTRATION REVIEW PROCESS IS BEING FOLLOWED, WHICH INCLUDES SALARY AND BENEFIT SURVEYS AND COMPARISONS OF ALL POSITIONS. THE CEO'S COMPENSATION IS SENT TO THE FULL BOARD FOR APPROVAL. THE COMPENSATION OF ALL OTHER KEY POSITIONS IS APPROVED BY THE CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE ONLINE THROUGH THE OFFICE OF THE ATTORNEY GENERAL VIA THE CHARITY REPORT FILED WITH THE STATE OF MINNESOTA. |
| FORM 990, PART IX, LINE 11G | MEDICAL FEES: PROGRAM SERVICE EXPENSES 13,998,442. MANAGEMENT AND GENERAL EXPENSES 2,818,524. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,816,966. COLLECTION AGENCY FEES: PROGRAM SERVICE EXPENSES 275,534. MANAGEMENT AND GENERAL EXPENSES 55,477. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 331,011. LAUNDRY FEES: PROGRAM SERVICE EXPENSES 533,764. MANAGEMENT AND GENERAL EXPENSES 107,471. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 641,235. SECURITY FEES: PROGRAM SERVICE EXPENSES 295,318. MANAGEMENT AND GENERAL EXPENSES 59,461. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 354,779. MISCELLANEOUS PURCHASED FEES: PROGRAM SERVICE EXPENSES 1,306,640. MANAGEMENT AND GENERAL EXPENSES 263,086. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,569,726. |
| FORM 990, PART XI, LINE 9: | RETURN OF CAPITAL TO MEMBERS -30,400,000. |
| FORM 990, PART XII, LINE 2C: | NEITHER THE OVERSIGHT PROCESS OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT CHANGED DURING THE CURRENT TAX YEAR. |
| FORM 990, PART XI, LINE 9: | RETURN OF CAPITAL TO MEMBERS: A RETURN OF CAPITAL IN THE AMOUNT OF $30,400,000 WAS MADE TO THE MEMBERS OF THE ORGANIZATION. THE MEMBERS CONSIST OF NORTH MEMORIAL HEATH CARE AND FAIRVIEW HEALTH SERVICES. ALL MEMBERS ARE REQUIRED TO BE NON-PROFIT, TAX EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C)(3) PER THE BYLAWS OF THE ORGANIZATION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL HEALTH CARE | |||||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 410729979 | ACUTE CARE | MN | 501(C)(3) | LINE 3 | NORTH MEMORIAL | 0 | |
| NORTH MEMORIAL FOUNDATION | |||||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 411777966 | FUNDRAISING | MN | 501(C)(3) | LINE 7 | NORTH MEMORIAL | 0 | |
| ASSOCIATED HEALTH ASSURANCE | |||||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 980343815 | INSURANCE | 501(C)(3) | LINE 12B, II | NORTH MEMORIAL | 0 | BD | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE LLC | |||||||
| 9855 HOSPITAL DRIVE | MAPLE GROVE | MN | 55369 | 260393039 | OUTPATIENT SURGERY | MN | N/A |
| MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC | |||||||
| 2955 XENIUM LANE SUITE 40 | PLYMOUTH | MN | 55441 | 352162215 | RADIOLOGY | MN | N/A |
| NORTH RADIATION THERAPY CENTER | |||||||
| 6950 FRANCE AVE S SUITE 200 | EDINA | MN | 55435 | 743069974 | RADIOLOGY | MN | N/A |
| BLAINE URGENCY CENTER LLC | |||||||
| 480 OSBORNE RD NE | FRIDLEY | MN | 55432 | 461630126 | URGENT CARE | MN | N/A |
| PLYMOUTH CITY CENTER MEDICAL BUILDING | |||||||
| 5700 SMETANA DRIVE SUITE 120 | MINNETONKA | MN | 55343 | 463883617 | MEDICAL OFFICE BUILDING | MN | N/A |
| MINNETONKA AMBULATORY SURGERY CENTER | |||||||
| 3300 OAKDALE AVE NORTH | ROBBINSDALE | MN | 55422 | 465653486 | OUTPATIENT SURGERY | MN | N/A |
| CRYSTAL IMAGING CENTER LLC | |||||||
| 2955 XENIUM LANE SUITE 40 | PLYMOUTH | MN | 55441 | 454265124 | RADIOLOGY | MN | N/A |
| MULTICARE SLEEP CENTER LLC | |||||||
| 10600 OLD COUNTY ROAD 15 | PLYMOUTH | MN | 55441 | 274833673 | OUTPATIENT SLEEP CENTER | MN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| OAKDALE HEALTH ENTERPRISES INC | |||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 411546422 | AMBULANCE | MN | N/A | C | 0 |
| NORTH COLLABORATIVE CARE | |||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 461680666 | PRIMARY CARE | MN | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTH MEMORIAL HEALTH CARE (CASH TRANSFER) | ||
| B | $22,800,000 | CASH |
| NORTH MEMORIAL HEALTH CARE (DEBT GUARANTEE) | ||
| E | $89,512,500 | AMOUNT GUARANTEE |
| NORTH MEMORIAL HEALTH CARE (LEASE PAYMENTS) | ||
| K | $458,957 | AMOUNT PAID |
| NORTH MEMORIAL HEALTH CARE (MANAGEMENT FEE) | ||
| R | $18,560,617 | AMOUNT PAID |
| NORTH MEMORIAL HEALTH CARE (SALARY REIMBURSEMENT) | ||
| P | $11,880,518 | AMOUNT PAID |