CENTRACARE HEALTH SYSTEM: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
CENTRACARE HEALTH SYSTEM (EIN 41-1813221)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-08
IRS object ID
201501289349300900
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-08T07:43:23-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1801 NICOLLET MALL SUITE 1100AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411813221EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTRACARE HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCENTBusinessNameControlTxt
Phone3202512700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11406 6TH AVENUE NORTHAddressLine1
CityST CLOUDCity
StateMNState
ZIP Code56303ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGREGORY R KLUGHERZPersonNm
Person TitleCFOPersonTitleTxt
Phone3202512700PhoneNum
Signature2015-04-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTODD A JACKSONPreparerPersonNm
PTINP00092672PTIN
Phone6123324300PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTERENCE R PLADSON MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11406 6TH AVENUE NORTHAddressLine1
CityST CLOUDCity
StateMNState
ZIP Code56303ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$178,492,147GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CENTRACARE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTHE CENTRACARE HEALTH SYSTEM WORKS TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee1284TotalEmployeeCnt
Total Volunteers349TotalVolunteersCnt
Total Gross UBI$422,632TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$43,599NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$39,006,808PYContributionsGrantsAmt
CY Contributions Grants$13,811,966CYContributionsGrantsAmt
PY Program Service Revenue$72,795,293PYProgramServiceRevenueAmt
CY Program Service Revenue$157,331,689CYProgramServiceRevenueAmt
PY Investment Income$1,446,528PYInvestmentIncomeAmt
CY Investment Income$692,785CYInvestmentIncomeAmt
PY Other Revenue$2,543,184PYOtherRevenueAmt
CY Other Revenue$733,069CYOtherRevenueAmt
PY Total Revenue$115,791,813PYTotalRevenueAmt
CY Total Revenue$172,569,509CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$9,751CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$21,761,867PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$70,142,368CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$688,664CYTotalFundraisingExpenseAmt
PY Other Expenses$66,510,057PYOtherExpensesAmt
CY Other Expenses$93,329,433CYOtherExpensesAmt
PY Total Expenses$88,271,924PYTotalExpensesAmt
CY Total Expenses$163,481,552CYTotalExpensesAmt
PY Revenues Less Expenses$27,519,889PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,087,957CYRevenuesLessExpensesAmt
Total Assets BOY$143,227,013TotalAssetsBOYAmt
Total Assets EOY$176,582,230TotalAssetsEOYAmt
Total Liabilities BOY$77,796,813TotalLiabilitiesBOYAmt
Total Liabilities EOY$90,797,825TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$65,430,200NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$85,784,405NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF CENTRACARE HEALTH SYSTEM (CCHS) IS TO OPERATE AN INTEGRATED MULTI-ORGANIZATIONAL HEALTH CARE SYSTEM DESIGNED TO PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES AT AN AFFORDABLE PRICE.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$53,032,858ExpenseAmt
Grant$9,751GrantAmt
Revenue$60,002,976RevenueAmt
DescCENTRACARE HEALTH SYSTEM (CCHS) IS AN INTEGRATED HEALTH SYSTEM, COMPRISED OF FOUR CRITICAL ACCESS HOSPITALS, ONE ACUTE CARE HOSPITAL, A MULTI-SPECIALTY CLINIC, SURGICAL CENTER, RETAIL PHARMACY NETWORK, NURSING HOME AND A FOUNDATION. CCHS SERVES ITS PATIENTS IN 4 MAIN AREAS:MONTICELLO HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. MONTICELLO HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL AND ALSO OPERATES A 10 BED ACUTE REHAB UNIT. IN FISCAL YEAR 2014, THEY HAD 4,554 PATIENT DAYS, 25,267 OUTPATIENT VISITS AND 10,815 EMERGENCY ROOM VISITS; WHICH GENERATED $63,503,196 OF PROGRAM REVENUE AND $57,289,207 OF PROGRAM EXPENSE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$22,301,434ExpenseAmt
Revenue$27,371,138RevenueAmt
DescCENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. CENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. IN FISCAL YEAR 2014, THEY HAD 1,729 PATIENT DAYS, 3,818 OUTPATIENT VISITS AND 2,295 EMERGENCY ROOM VISITS; WHICH GENERATED $27,371,138 OF PROGRAM REVENUE AND $22,301,434 OF PROGRAM EXPENSE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$22,250,714ExpenseAmt
Revenue$25,706,485RevenueAmt
DescCENTRACARE LABORATORY SERVICES ALL HOSPITALS UNDER ITS UMBRELLA AS WELL AS CENTRACARE CLINIC. IT ALSO PERFORMS TESTS FOR VARIOUS FACILITIES IN THE REGION. CENTRACARE LABORATORY PERFORMED 1.7 MILLION TESTS IN FISCAL YEAR 2014; WHICH GENERATED $31,739,156 IN PROGRAM REVENUE AND INCURRED $22,250,714 OF EXPENSES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$16,405,454ExpenseAmt
Revenue$44,567,093RevenueAmt
DescTHE OTHER MAIN ACTIVITY OF CENTRACARE HEALTH SYSTEM IS THE INFORMATION TECHNOLOGY SERVICES PROVIDED TO ALL ENTITIES WITHIN THE CENTRACARE UMBRELLA. ACTIVITIES INCLUDE FIELDING HELP DESK CALLS, INSTALLING SOFTWARE AND HARDWARE, MAINTAINING THE SERVERS, AND OTHER RELATED INFORMATION SYSTEM TASKS. THE REVENUE GENERATED FROM THIS ACTIVITY IN FISCAL YEAR 2014 WAS $38,992,238 AND GENERATED EXPENSES OF $10,744,688CENTRACARE SURGICAL CENTER (CCSC) PROVIDES SURGICAL SERVICES TO THE COMMUNITY IT SERVES. IN FISCAL YEAR 2014 THERE WERE 3,413 SURGERIES PERFORMED. CCSC GENERATED $5,574,855 OF REVENUE AND $5,660,766 OF EXPENSE FOR AN OPERATING LOSS OF $85,911.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$16,405,454TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$44,567,093TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$113,990,460TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document155IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1284EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREGORY R KLUGHERZBusinessNameLine1
FieldValueIRS element (for citing)
Phone3202512700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11406 SIXTH AVENUE NORTHAddressLine1
CityST CLOUDCity
StateMNState
ZIP Code56303ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
TERENCE R PLADSON MD
PRESIDENT/CEO40.004.00Yes (X)Yes (X)$1,357,426$0$251,324
GENE WINDFELDT
DIRECTOR, CHAIR2.001.00Yes (X)Yes (X)$5,000$0$0
ROBERT WHITE
DIRECTOR, VICE CHAIR2.001.00Yes (X)Yes (X)$2,500$0$0
THOMAS W LEITHER MD
DIRECTOR & NEPHROLOGIST2.0040.00Yes (X)$0$410,968$40,376
CHRISTOPHER COBORN
DIRECTOR2.002.00Yes (X)$2,000$0$0
DAVID AGERTER MD
DIRECTOR2.001.00Yes (X)$1,000$0$0
DENISE ROSIN
DIRECTOR2.001.00Yes (X)$2,000$0$0
MIKE BENUSA
DIRECTOR2.001.00Yes (X)$2,500$0$0
GARY MARSDEN
DIRECTOR2.001.00Yes (X)$2,000$0$0
MOHAMED YASSIN MD
DIRECTOR2.001.00Yes (X)$2,500$0$0
MARY JO WILLIAMSON
DIRECTOR2.001.00Yes (X)$1,500$0$0
ROBERT STOCKER MD
DIRECTOR & OB/GYN2.0038.00Yes (X)$0$536,750$19,125
JOSEPH UPHUS
DIRECTOR2.001.00Yes (X)$1,000$0$0
GREGORY R KLUGHERZ
TREASURER/CFO14.0027.00Yes (X)$0$628,226$126,100
PAUL R HARRIS
CORPORATE SECRETARY25.0016.00Yes (X)$434,166$0$77,979
JAMES R DAVIS
VICE PRESIDENT25.0015.00$386,595$0$26,538Yes (X)
ERIC M LOHN
REGIONAL CFO8.0032.00$161,181$0$14,414Yes (X)
GERRY G GILBERTSON
ADMINISTRATOR-MELROSE0.5039.50$258,228$0$41,761Yes (X)
DANIEL J SWENSON
ADMINISTRATOR-LONG PRAIRIE0.5039.50$240,472$0$50,657Yes (X)
DELANO A CHRISTANSON
ADMINISTRATOR - SAUK CENTRE0.5039.50$156,451$0$48,011Yes (X)
MARY E WELLS
ADMINISTRATOR - MONTICELLO40.000.50$201,942$0$7,261Yes (X)
JOSEPH D HELLIE
VICE PRESIDENT1.0039.00$0$175,619$35,458Yes (X)
JOSEPH M BLONSKI MD
PHYSICIAN40.00$287,371$0$40,107Yes (X)
MARK J LARKIN
VICE PRESIDENT OF DEVELOPMENT40.00$284,177$0$64,499Yes (X)
MARY V PHIPPS
DIRECTOR40.00$217,665$0$40,295Yes (X)
KEVIN R SWITZER
ASSOCIATE DIRECTOR40.00$208,741$0$31,215Yes (X)
JIMMIE L BROWNING
ASSOCIATE DIRECTOR40.00$206,908$0$582Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,423,323TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,751,563TotReportableCompRltdOrgAmt
Total Other Compensation$915,702TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K40IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
CENTRAL MINNESOTA EMERGENCY PHYSICIANS
1406 6TH AVE NORTHST CLOUDMN56303EMERGENCY COVERAGE$4,398,498
MAYO MEDICAL LABORATORIES
PO BOX 4100ROCHESTERMN559034100LABORATORY SERVICES$3,601,500
CENTRACARE CLINIC
1200 6TH AVE NST CLOUDMN56303PHYSICIAN SERVICES$2,097,531
METRO ANESTHESIA CONSULTANT
9855 AETNA AVE NEMONTICELLOMN55362ANESTHESIA SERVICES$1,427,367
CENTRAL MINNESOTA DIAGNOSTIC INC
150 10TH STREET NWMILACAMN56353RADIOLOGY SERVICES$1,403,187
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt
Related Organizations$13,730,043RelatedOrganizationsAmt
Government Grants$52,066GovernmentGrantsAmt
All Other Contributions$29,857AllOtherContributionsAmt
Noncash Contributions$13,730,043NoncashContributionsAmt
Total Contributions$13,811,966TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT & SERVICE REVENUE900099$118,496,478$118,073,846$422,632
CORPORATE REVENUE900099$20,673,639$20,673,639
HEALTH INSURANCE PREMIUM CREDIT900099$10,724,143$10,724,143
SHARED/LEGAL SYSTEM REVENUE900099$4,621,370$4,621,370
OTHER REVENUE900099$1,736,796$1,736,796

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,079,263TotalRevenueColumnAmt
Related Or Exempt Func Income$1,079,263RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$157,331,689TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$671,369TotalRevenueColumnAmt
Exclusion$671,369ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$5,856,545RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$5,856,545RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$52,801OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$31,385OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$21,416OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,416TotalRevenueColumnAmt
Exclusion$21,416ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$29,142GrossSalesOfInventoryAmt
Cost Of Goods Sold$34,708CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$5,566TotalRevenueColumnAmt
Exclusion-$5,566ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescREVENUE FROM JOINT VENTURESDesc
Business900099BusinessCd
Total Revenue Column$738,635TotalRevenueColumnAmt
Related Or Exempt Func Income$738,635RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$738,635OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$172,569,509TotalRevenueColumnAmt
Related Or Exempt Func Income$157,647,692RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$422,632UnrelatedBusinessRevenueAmt
Exclusion$687,219ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$9,751TotalAmt
Program Services$9,751ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,678,475TotalAmt
Management And General$3,678,475ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$53,311,454TotalAmt
Program Services$51,968,892ProgramServicesAmt
Management And General$1,322,389ManagementAndGeneralAmt
Fundraising$20,173FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,743,149TotalAmt
Program Services$2,585,464ProgramServicesAmt
Management And General$136,380ManagementAndGeneralAmt
Fundraising$21,305FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,116,946TotalAmt
Program Services$6,643,245ProgramServicesAmt
Management And General$473,701ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,292,344TotalAmt
Program Services$2,925,700ProgramServicesAmt
Management And General$273,244ManagementAndGeneralAmt
Fundraising$93,400FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$839,029TotalAmt
Program Services$8,194ProgramServicesAmt
Management And General$830,284ManagementAndGeneralAmt
Fundraising$551FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$117,803TotalAmt
Program Services$4,054ProgramServicesAmt
Management And General$113,749ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$19,169,811TotalAmt
Program Services$17,428,744ProgramServicesAmt
Management And General$1,493,542ManagementAndGeneralAmt
Fundraising$247,525FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$404,519TotalAmt
Program Services$113,768ProgramServicesAmt
Management And General$198,859ManagementAndGeneralAmt
Fundraising$91,892FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,157,837TotalAmt
Program Services$1,533,524ProgramServicesAmt
Management And General$567,589ManagementAndGeneralAmt
Fundraising$56,724FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$34,655,546TotalAmt
Management And General$34,655,546ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$541,427TotalAmt
Program Services$541,418ProgramServicesAmt
Fundraising$9FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$61,177TotalAmt
Program Services$21,261ProgramServicesAmt
Management And General$28,664ManagementAndGeneralAmt
Fundraising$11,252FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$436,872TotalAmt
Program Services$283,422ProgramServicesAmt
Management And General$131,131ManagementAndGeneralAmt
Fundraising$22,319FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,004,137TotalAmt
Program Services$251,726ProgramServicesAmt
Management And General$1,752,410ManagementAndGeneralAmt
Fundraising$1FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,920,941TotalAmt
Program Services$3,188,979ProgramServicesAmt
Management And General$729,250ManagementAndGeneralAmt
Fundraising$2,712FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,128,945TotalAmt
Program Services$286,997ProgramServicesAmt
Management And General$840,374ManagementAndGeneralAmt
Fundraising$1,574FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES/DRUGS$15,385,583$15,356,363$29,181$39
BAD DEBT$3,062,479$3,062,479
MEDICAID SURCHARGE/MN C$1,896,420$1,896,420

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$7,546,907TotalAmt
Program Services$5,880,059ProgramServicesAmt
Management And General$1,547,660ManagementAndGeneralAmt
Fundraising$119,188FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$163,481,552TotalAmt
Program Services$113,990,460ProgramServicesAmt
Management And General$48,802,428ManagementAndGeneralAmt
Fundraising$688,664FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$10,231,691BOYAmt
EOY$15,715,128EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,265,272BOYAmt
EOY$496,690EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$19,634,313BOYAmt
EOY$36,583,201EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,499,031BOYAmt
EOY$1,437,263EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,087,353BOYAmt
EOY$2,676,939EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,362,576BOYAmt
EOY$1,386,050EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$184,140,855LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$98,096,239LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$78,626,884BOYAmt
EOY$86,044,616EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$25,899,853BOYAmt
EOY$31,747,194EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$620,040BOYAmt
EOY$495,149EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$143,227,013BOYAmt
EOY$176,582,230EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$26,776,918BOYAmt
EOY$33,618,221EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$406,109BOYAmt
EOY$138,928EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,688,542BOYAmt
EOY$42,425,678EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,634,889BOYAmt
EOY$8,903,231EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,290,355BOYAmt
EOY$5,711,767EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$77,796,813BOYAmt
EOY$90,797,825EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$65,430,200BOYAmt
EOY$85,784,405EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$65,430,200BOYAmt
EOY$85,784,405EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$143,227,013BOYAmt
EOY$176,582,230EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$9,087,957ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$212,245NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$11,054,003OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
CertificationYes (X)CertificationInd
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp (7 entries)

EINEINOrganization TypeOrganizationTypeDescGoverning Document ListedGoverningDocumentListedIndSupported Org NotifiedSupportedOrgNotifiedIndUS OrganizedUSOrganizedIndSupportSupportAmt
ST CLOUD HOSPITAL
410695596501(C)(3)Yes (1)Yes (1)Yes (1)$85,339,151
CENTRACARE CLINIC
411806657501(C)(3)Yes (1)Yes (1)Yes (1)$21,220,438
CENTRACARE HEALTH SYSTEM - MELROSE
411865315501(C)(3)Yes (1)Yes (1)Yes (1)$3,123,891
CENTRACARE HEALTH SYSTEM - LONG PRAIRIE
411924645501(C)(3)Yes (1)Yes (1)Yes (1)$3,020,766
CENTRAL MINNESOTA EMERGENCY PHYSICIANS
411708142501(C)(3)Yes (1)Yes (1)Yes (1)$1,575,476
CENTRACARE HEALTH FOUNDATION
411855173501(C)(3)Yes (1)Yes (1)Yes (1)$286,798
CENTRACARE HEALTH SYSTEM - SAUK CENTRE
452438973501(C)(3)Yes (1)Yes (1)Yes (1)$3,276,422
FieldValueIRS element (for citing)
Supported Organizations Total7SupportedOrganizationsTotalCnt
Support Sum$117,842,942SupportSumAmt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$8,534OtherActivitiesAmt
Total Lobbying Expenditures$8,534TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationCCHS PAYS DUES TO THE MINNESOTA HOSPITAL ASSOCIATION (MHA) AND AMERICAN MEDICAL GROUP, A PORTION OF WHICH RELATES TO LOBBYING ACTIVITIES. FOR FY2014, MHA HAS DETERMINED THAT 3.8% OR $5,784 OF ITS MEMBERSHIP DUES WERE USED FOR LOBBYING PURPOSES. THE AMERICAN MEDICAL GROUP HAS DETERMINED THAT 20% OR $2,750 OF ITS MEMBERSHIP DUES WERE USED FOR LOBBYING PURPOSES. THE TOTAL LOBBYING EXPENSES FOR FY14 TOTALED $8,534.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,777,911OtherCostOrOtherBasisAmt
Book Value$8,777,911BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$123,546,076OtherCostOrOtherBasisAmt
Depreciation$57,210,098DepreciationAmt
Book Value$66,335,978BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$51,317,901OtherCostOrOtherBasisAmt
Depreciation$40,886,141DepreciationAmt
Book Value$10,431,760BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$498,967OtherCostOrOtherBasisAmt
Book Value$498,967BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$86,044,616TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
FUNDS HELD BY TRUSTEE UNDER BOND INDENTURES$14,718,440C
FUNDS HELD BY BOARD FOR FUTURE PROPERTY & EQUIP REPLACEMENT/EXPANSION$8,420,539C
INVESTMENT IN JOINT VENTURES$5,707,930C
INVEST IN MUTUAL SERVICE CORP$2,900,285C
FieldValueIRS element (for citing)
Total Book Value Securities$31,747,194TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
EXECUTIVE BENEFIT ACCRUAL$2,900,285
LT SETTLEMENT RESERVES$1,151,751
PENSION ACCRUAL$278,853
CONTINGENT CONSIDERATION$1,380,878
FieldValueIRS element (for citing)
Total Liability$5,711,767TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other175.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$466,299TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$466,299NetCommunityBenefitExpnsAmt
Total Expense0.00510TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,360,566TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,215,344DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,145,222NetCommunityBenefitExpnsAmt
Total Expense0.01250TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,826,865TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,215,344DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,611,521NetCommunityBenefitExpnsAmt
Total Expense0.01760TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,398TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$21,398NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,667TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,667NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$34,065TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$34,065NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,860,930TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,215,344DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,645,586NetCommunityBenefitExpnsAmt
Total Expense0.01790TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,911,312BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$25,674,704ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$25,845,544CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$170,840MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 MONTICELLO CANCER CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Primary ActivitiesRADIATION & ONCOLOGY SERVICESPrimaryActivitiesTxt
Org Profit Or Ownership0.60000OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.00000OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.00000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndCritical Access HospitalCriticalAccessHospitalIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDesc
CENTRACARE HEALTH - MONTICELLO
11013 HART BLVDMONTICELLOMN55362Yes (X)Yes (X)Yes (X)Yes (X)DISTINCT PART REHAB
CENTRACARE HEALTH - PAYNESVILLE
2200 WEST FIRST STREETPAYNESVILLEMN56362Yes (X)Yes (X)Yes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndInformation GapsInformationGapsIndOtherOtherIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtRpt Available Upon RequestRptAvailableUponRequestIndRpt Available Thru Other MethodRptAvailableThruOtherMethodIndOther Needs AddressedOtherNeedsAddressedIndAll Needs AddressedAllNeedsAddressedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareIndFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctExplained BasisExplainedBasisIndIncome LevelIncomeLevelIndApp Financial Asst ExplnAppFinancialAsstExplnIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndPosted On WebsitePostedOnWebsiteIndAttached To InvoiceAttachedToInvoiceIndPosted In Emergency RoomPostedInEmergencyRoomIndPosted In Admission OfficePostedInAdmissionOfficeIndAvailable On RequestAvailableOnRequestIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit LawsuitPermitLawsuitIndPermit Other ActionsPermitOtherActionsIndCollection ActivitiesCollectionActivitiesIndLawsuitLawsuitIndOther ActionsOtherActionsIndFAP Notified Before DischargeFAPNotifiedBeforeDischargeIndFAP Notified All PatientsFAPNotifiedAllPatientsIndDocumented Elig DeterminationDocumentedEligDeterminationIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndOther Method UsedOtherMethodUsedIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
CENTRACARE HEALTH - MONTICELLO
1Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)12Yes (1)Yes (1)Yes (1)Yes (X)WWW.CENTRACARE.COMYes (X)Yes (X)Yes (X)Yes (1)0Yes (1)Yes (1)175.000000000000Yes (1)250.000000000000Yes (1)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
CENTRACARE HEALTH - PAYNESVILLE
20Yes (1)Yes (1)175.000000000000Yes (1)250.000000000000Yes (1)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 1J: CCH'S CHNA PROCESS ALSO CONSIDERED SECONDARY DATA FROM THE DARTMOUTH ATLAS, ROBERT WOOD JOHNSON, MINNESOTA DEPARTMENT OF HEALTH, US CENSUS BUREAU, MINNESOTA HOSPITAL ASSOCIATION, ST. CLOUD AREA UNITED WAY, CATHOLIC CHARITIES OF THE DIOCESE OF ST. CLOUD, MINNESOTA SENIOR FEDERATION, PUBLIC HEALTH DEPARTMENTS FROM APPROPRIATE COUNTIES AND ADDITIONAL FEDERAL AND STATE ENTITIES.THE CHNA WAS INFORMED BY A COLLABORATIVE AND ONGOING COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH A NUMBER OF AREA COUNTIES WHO WERE JOINTLY CONDUCTING COMMUNITY SURVEYS TO INFORM THEIR COMMUNITY HEALTH ASSESSMENTS IN SUPPORT OF DEVELOPMENT OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS.LACK OF CURRENT PUBLIC HEALTH DATA WAS A SIGNIFICANT INFORMATION GAP IN THE CHNA AS THE SURVEY COULD NOT BE COMPLETED IN TIME TO INCLUDE ITS DATA IN THE CCH CHNA. CCH HAS COMMITTED TO A CONTINUING EFFORT WITH PUBLIC HEALTH OFFICIALS TO JOINTLY DEVELOP PRIORITIES WITH THE COUNTIES AS A PART OF ITS ACTION PLANS.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 1J: CENTRACARE HEALTH - PAYNESVILLE BECAME PART OF THE CENTRACARE HEALTH SYSTEM (CCHS) GROUP ON OCTOBER 1, 2013. CCHS CONDUCTED ITS MOST RECENT CHNA JOINTLY WITH ALL OF ITS 501(C)(3) HOSPITALS AS OF THE BEGINNING OF ITS FISCAL YEAR 2013 (7/1/2012). BECAUSE PAYNESVILLE WAS NOT PART OF THE CCH GROUP AS OF 7/1/2012 IT WAS NOT INCLUDED IN THE MOST RECENT CHNA.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 3: DATA WAS OBTAINED FROM LOCAL COUNTY PUBLIC HEALTH DEPARTMENTS, INCLUDING THEIR MOST RECENT HEALTH ASSESSMENTS AND COMMUNITY REPORTS. IN ADDITION, HEALTH-RELATED INFORMATION WAS COLLECTED FROM AREA NONPROFIT ORGANIZATIONS THAT REGULARLY CONDUCT ASSESSMENTS AND EVALUATIONS OF THE SERVICES THEY PROVIDE AND THEIR TARGETED DEMOGRAPHICS. USEFUL MATERIAL WAS GATHERED FROM THE LOCAL UNITED WAY, CATHOLIC CHARITIES, THE CENTRAL MINNESOTA COUNCIL ON AGING, AND THE TRI-COUNTY ACTION PROGRAM (TRI-CAP). THESE ORGANIZATIONS SUPPORT A BROAD RANGE OF CONSTITUENTS WITH DIVERSE HEALTH-RELATED NEEDS; THEY REPRESENT DEMOGRAPHICS THAT ARE STATISTICALLY MORE LIKELY TO ENCOUNTER HEALTH-RELATED BARRIERS. CCH ALSO CONDUCTED A SERIES OF FOCUS GROUPS THAT INFORMED ITS CHNA. SPECIFICALLY, THE FOCUS GROUPS REPRESENTED POPULATIONS OF COLOR, RECENT IMMIGRANT POPULATIONS, CULTURAL MINORITIES, THOSE WHO WERE AUDIBLY CHALLENGED AND OTHERS WHO WERE DEEMED TO BE UNDER-REPRESENTED OR UNDER-SERVED.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 4: CCH CONDUCTED ITS CHNA JOINTLY WITH ALL OF ITS 501(C)(3) HOSPITALS AS OF THE BEGINNING OF ITS FISCAL 2013. THOSE FACILITIES INCLUDED ST. CLOUD HOSPITAL, CENTRACARE HEALTH MELROSE, CENTRACARE HEALTH LONG PRAIRIE, CENTRACARE HEALTH SAUK CENTRE AND CENTRACARE HEALTH - MONTICELLO.EACH HOSPITAL PREPARED INDIVIDUAL ACTION PLANS TO THE CHNA BASED ON SPECIFIC INPUT FROM THOSE COMMUNITIES.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 5D: IN ADDITION TO MAKING ITS CHNA AVAILABLE TO THE PUBLIC ON ITS WEB SITE AND AT ITS BUSINESS OFFICE, CCH HAS SHARED COPIES OF THE CHNA WITH COUNTY PUBLIC HEALTH OFFICIALS AND, INTERNALLY, WITH INDIVIDUALS WORKING ON QUALITY IMPROVEMENT AND COMMUNITY HEALTH INITIATIVES.CCH HAS ALSO PUBLISHED CONTACT INFORMATION FOR ITS DIRECTOR OF COMMUNITY & GOVERNMENT RELATIONS TO RESPOND TO QUESTIONS OR CONCERNS ABOUT THE CHNA. THE DIRECTOR HAS ALSO PRESENTED RESULTS OF THE CHNA TO COMMUNITY GROUPS AND TO REPRESENTATIVES OF LOCAL FUNDING GROUPS.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 6I: THE NEEDS IDENTIFIED BY THE CHNA ARE CURRENTLY IN ORGANIZATIONAL WORK PLANS AND ARE UNDER IMPLEMENTATION.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 7: PER GUIDANCE FROM THE IRS, REGULATION 1.501(R)-3(C), THE CHNA FOR CCH ELECTED NOT TO DIRECTLY ADDRESS SEVERAL DETERMINANTS OF HEALTH THAT IT IDENTIFIED IN ITS PROCESS WHICH WERE NOT WITHIN THE ORGANIZATION'S CAPABILITIES OR CORE COMPETENCIES. EXAMPLES OF ISSUES NOT SPECIFICALLY ADDRESSED IN THE CHNA ACTION PLANS INCLUDE HIGH SCHOOL GRADUATION RATES, AFFORDABLE HOUSING OR SUPPORTED HOUSING. (CCH DID SUPPORT AN EFFORT OF THE CITY OF ST. CLOUD TO CONDUCT A HOUSING ASSESSMENT AS A RESULT OF THE CHNA PROCESS AND IS ALREADY THE LARGEST AREA PROVIDER OF SUPPORTED HOUSING DUE TO ITS EXTENSIVE CHEMICAL DEPENDENCY PROGRAMS AND SENIOR HOUSING PROGRAMS.)
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 16E: THE ORGANIZATION EMPLOYES THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE LAWSUITS AS WELL.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 16E: THE ORGANIZATION EMPLOYES THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE LAWSUITS AS WELL.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 17E: THE ORGANIZATION CONTRACTS WITH SEVERAL COLLECTION AGENCIES TO ATTEMPT TO COLLECT PATIENT BALANCES.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 17E: THE ORGANIZATION CONTRACTS WITH SEVERAL COLLECTION AGENCIES TO ATTEMPT TO COLLECT PATIENT BALANCES.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 20D: PER AGREEMENT WITH THE MINNESTOA ATTORNEY GENERAL, THE ORGANIZATION PROVIDES A DISCOUNT TO THE UNINSURED EQUAL TO THE AVERAGE DISCOUNT OF OUR LARGEST (BY VOLUME) NON-GOVERNMENTAL PAYOR.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 20D: PER AGREEMENT WITH THE MINNESTOA ATTORNEY GENERAL, THE ORGANIZATION PROVIDES A DISCOUNT TO THE UNINSURED EQUAL TO THE AVERAGE DISCOUNT OF OUR LARGEST (BY VOLUME) NON-GOVERNMENTAL PAYOR.
FieldValueIRS element (for citing)
Facility8FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
MONTICELLO CARE CENTER
1104 EAST RIVER STREETMONTICELLOMN55362SKILLED NURSING FACILITY
MONTICELLO CLINIC
1001 HART BLVD STE 100MONTICELLOMN55362CLINIC
KORONIS MANOR CARE CENTER
200 WEST FIRST STREETPAYNESVILLEMN56362SKILLED NURSING FACILITY
CCH PAYNESVILLE- BELGRADE CLINIC
505 NELSON AVENUEBELGRADEMN56312CLINIC
CCH PAYNESVILLE - COLD SPRING CLINIC
308 FIFTH AVENUE SOUTHCOLD SPRINGMN56320CLINIC
CCH PAYNESVILLE - EDEN VALLEY CLINIC
405 MEEKER AVENUEEDEN VALLEYMN56362CLINIC
CCH PAYNESVILLE - PAYNESVILLE CLINIC
200 WEST FIRST STREETPAYNESVILLEMN56362CLINIC
CCH PAYNESVILLE - RICHMOND CLINIC
130 FIRST STREET NERICHMONDMN56368CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE HOSPITALS' TOTAL EXPENSES (NET OF BAD DEBT) WERE REDUCED BY OTHER OPERATING REVENUE (NET OF EHR INCENTIVE REVENUE) AND ALSO BY MEDICAID SURCHARGE AND TAXES, AND THEN DIVIDED BY TOTAL PATIENT REVENUE TO DETERMINE COST TO CHARGE RATIO.
PART I, LN 7 COL(F):THE HOSPITALS' BAD DEBT EXPENSE WAS ESTIMATED USING THE COST TO CHARGE RATIO DESCRIBED IN PART I, LINE 7 AND MULTIPLYING BY TOTAL BAD DEBTS (WHICH ARE WRITTEN OFF AT GROSS CHARGES UNLESS A SELF PAY DISCOUNT WAS TAKEN ON THE ACCOUNT PRIOR TO BEING WRITTEN OFF).
PART III, LINE 4:THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 OF THE ORGANIZATION'S AUDITED FINANCIALS."PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS, CONSIDERING HISTORICAL NET COLLECTION, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUECY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CENTRACARE FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICITONS ON COLLECTION EFFORTS AS DETERMINED BY CENTRACARE."
PART III, LINE 8:THE SHORTFALL OF $171 THOUSAND IN TREATING MEDICARE PATIENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT IN ITS ENTIRETY. THE HOSPITALS PROVIDE AN EXCELLENT LEVEL OF CARE TO THE PEOPLE IN THE COMMUNITY. DESPITE THE SHORTFALL IN REIMBURSEMENT FORM MEDICARE, THE HOSPITALS CONTINUE TO PROVIDE ESSENTIAL HEALTHCARE SERVICES TO THE POPULATION. THE AMOUNT ON LINE 7 OF PART III WAS DETERMINED BY UTILIZING THE MEDICARE COST REPORT UTILIZING KEY SECTIONS OF THAT REPORT, PRIMARILY THE D SERIES AND E SERIES.
PART III, LINE 9B:THE COLLECTION POLICIES AT THE HOSPITALS REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE, IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT RATING AGENCIES.
PART VI, LINE 2:NO NEEDS ASSESSMENT WAS COMPLETED IN 2013.
PART VI, LINE 3:INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE HOSPITALS' BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE.
PART VI, LINE 4:CENTRACARE HEALTH - MONTICELLO IS LOCATED IN CENTRAL MINNESOTA IN WRIGHT COUNTY. THE 2010 CENSUS SHOWS A POPULATION OF 11,553 WHICH WAS A 46.84% INCREASE OVER THE 2000 FIGURE OF 7,867. THIS AREA OF THE STATE IS SHOWING A SIGNIFICANT INCREASE IN POPULATION AND IS EXPECTED TO CONTINUE INTO THE FUTURE. THE AGE DEMOGRAPHICS OF THE REGION ARE AS FOLLOWS: 0-5: 13.34% 6-11: 10.95%, 12 TO 17: 10.01%, 18 TO 24: 9.17%, 25-34: 18.61%, 35-44: 13.77%, 45-54: 10.01%, 55-64: 6.73%, 65-74: 3.38%, 75-84: 2.50%, 85+: 1.54%.THE 2010 CENSUS DATA ETHNICITY BREAKDOWN FOR MONTICELLO, MN WAS AS FOLLOWS: CAUCASIAN: 92.47%, HISPANIC: 3.54%, ASIAN: 1.06%, AFRICAN AMERICAN: 1.03%, OTHER: 3.6%.CENTRACARE HEALTH - PAYNESVILLE IS LOCATED IN CENTRAL MINNESOTA IN STEARNS COUNTY. THE 2010 CENSUS SHOWS A POPULATION OF 2,115 WHICH WAS A 6.70% DECREASE OVER THE 2000 FIGURE OF 2,267. THIS AREA OF THE STATE IS SHOWING A SLIGHT DECREASE IN POPULATION AND IS EXPECTED TO CONTINUE INTO THE FUTURE. THE AGE DEMOGRAPHICS OF THE REGION ARE AS FOLLOWS: 0-5: 8.04% 6-11: 7.14%, 12 TO 17: 8.89%, 18 TO 24: 7.85%, 25-34: 10.07%, 35-44: 11.49%, 45-54: 13.19%, 55-64: 12.53%, 65-74: 8.18%, 75-84: 3.91%, 85+: 4.87%.THE 2010 CENSUS DATA ETHNICITY BREAKDOWN FOR PAYNESVILLE, MN WAS AS FOLLOWS: CAUCASIAN: 97.21%, HISPANIC: 2.32%, ASIAN: .38%, AND AFRICAN AMERICAN: .09%.
PART VI, LINE 5:THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IN SEVERAL IMPORTANT WAYS. ONE OF THESE WAYS IS THROUGH THE COMMUNITY COLLABORATION COMMITTEE (CCC), A STANDING COMMITTEE OF THE CENTRACARE HEALTH FOUNDATION. THE CCC HAS A MEMBERSHIP OF OVER 30 PERSONS REPRESENTING HEALTHCARE AND COMMUNITY NEEDS ACROSS CENTRAL MINNESOTA. THE CCC MEETS MONTHLY TO DISCUSS WAYS TO ADDRESS TYPICAL HEALTH ISSUES THROUGH AWARENESS BUILDING, EDUCATION AND/OR AN INTERVENTION PROJECT. THERE ARE SEVERAL COMMUNITY HEALTH OUTREACH INITIATIVES THAT THE FOUNDATION IS INVOLVED WITH. THESE INITIATIVES INCLUDE: 1) BLEND CHILDHOOD OBESITY COALITION OF CENTRAL MINNESOTA (GOAL IS TO REDUCE THE INCIDENCE OF CHILDHOOD OBESITY BY 2016), 2) SMOKE FREE COMMUNITIES (CONTINUED EFFORTS TO CREATE CLEAN INDOOR AND OUTDOOR AIR FOR ALL), 3) QUITPLAN CLINICS (COLLABORATION WITH CENTRACARE CLINIC TO HELP THOSE TRYING TO QUIT SMOKING), AND 4) CENTRACARE CLINIC MEDICAL HOME PILOT.
PART VI, LINE 6:THE HOSPITALS ARE PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE.
PART VI, LINE 7, REPORTS FILED WITH STATESMN

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1PAYNESVILLE SCHOOLSBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1795 W BUSINESS HIGHWAY 23AddressLine1
CityPAYNESVILLECity
StateMNState
ZIP Code56365ZIPCode
FieldValueIRS element (for citing)
Recipient EIN416004060RecipientEIN
Cash Grant$5,000CashGrantAmt
Purpose Of GrantSUPPORT OF THE LEAD THE WAY PROGRAMPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationCENTRACARE HEALTH SYSTEM, INCLUDING ST. CLOUD HOSPITAL, HAS THE FOLLOWING POLICY REGARDING CHARITABLE CONTRIBUTIONS: CONTRIBUTIONS MUST BE IN KEEPING WITH THE MISSION OF CENTRACARE HEALTH, WHICH IS TO WORK TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. CONTRIBUTIONS WILL BE MADE TO ORGANIZATIONS RATHER THAN TO INDIVIDUALS WITHIN THE CENTRAL MINNESOTA REGION. CENTRACARE'S CHARITABLE FUNDS MAY NOT BE USED TO SUPPORT ANY ORGANIZATION OR EVENT THAT WOULD RESULT IN BENEFITS OF ANY KIND TO AN EMPLOYEE OF THE HEALTH SYSTEM OR A MEMBER OF THE VARIOUS BOARDS OF DIRECTORS, EITHER DIRECTLY OR INDIRECTLY. ONE EXCEPTION EXISTS TO THE GUIDELINE REGARDING BENEFIT TO EMPLOYEES: WE WILL SUPPORT, VIA SCHOLARSHIPS AND THE PURCHASE OF SUPPLIES, THE MEDICAL MISSION WORK OF OUR STAFF AND PHYSICIANS. THE CENTRACARE HEALTH CONTRIBUTIONS COMMITTEE IS MADE UP OF : ONE REPRESENTATIVE FROM CENTRACARE HEALTH FOUNDATION; ONE REPRESENTATIVE FROM ST. CLOUD HOSPITAL HUMAN RESOURCES/DIVERSITY COMMITTEE; THE DIRECTOR OF CENTRACARE HEALTH'S COMMUNICATION DEPARTMENT AND THE COMMUNICATIONS/MARKETING FOR ST. BENEDICT'S SENIOR COMMUNITY; THE DIRECTOR OF CENTRACARE HEALTH'S MARKETING DEPARTMENT; THE DIRECTOR OF ST. CLOUD HOSPITAL VOLUNTEER SERVICES; AND ST. CLOUD HOSPITAL'S DIRECTOR OF MISSION & SPIRITUAL CARE. THE COMMITTEE MEETS MONTHLY TO ENSURE A STREAMLINED, COORDINATED PROCESS OF REVIEWING REQUESTS AND DETERMINING FUNDING. THE COMMITTEE MAINTAINS A DATABASE TO TRACK ALL CONTRIBUTIONS. OTHER CENTRACARE ENTITIES, INCLUDING CENTRACARE HEALTH - LONG PRAIRIE, MELROSE, MONTICELLO, PAYNESVILLE AND SAUK CENTRE, MAY DEVELOP A BUDGET FOR APPROVAL AND IMPLEMENT THEIR OWN CONTRIBUTIONS DECISIONS WITHIN THE GUIDELINES OF THIS DOCUMENT. CONTRIBUTIONS MAY NOT EXCEED THE STATED BUDGET AND NO MULTI-YEAR COMMITMENTS TO ORGANIZATIONS MAY BE MADE WITHOUT APPROVAL FORM THE CENTRACARE HEALTH EXECUTIVE COUNCIL. INDIVIDUALS AND DEPARTMENTS FORM THROUGHOUT ST. CLOUD HOSPITAL AND CENTRACARE CLINIC SHOULD FORWARD ALL OUTSIDE FUNDING REQUESTS TO A MEMBER OF THE COMMITTEE FOR THE FULL GROUP'S CONSIDERATION. THOSE REQUESTING FUNDS SHOULD BE ASKED TO SUBMIT REQUESTS IN WRITING.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TERENCE R PLADSON MD
PRESIDENT/CEO$852,388$0$268,267$0$236,771$0$235,050$0$20,959$0$1,613,435$0$225,588$0
THOMAS W LEITHER MD
DIRECTOR & NEPHROLOGIST$0$350,424$0$55,202$0$5,342$0$19,002$0$22,128$0$452,098$0$0
ROBERT STOCKER MD
DIRECTOR & OB/GYN$0$445,755$0$90,360$0$635$0$19,125$0$3,295$0$559,170$0$0
GREGORY R KLUGHERZ
TREASURER/CFO$0$422,200$0$96,448$0$109,578$0$110,826$0$19,039$0$758,091$0$84,515
PAUL R HARRIS
CORPORATE SECRETARY$300,778$0$63,000$0$70,388$0$52,913$0$33,817$0$520,896$0$67,504$0
JAMES R DAVIS
VICE PRESIDENT$284,429$0$48,737$0$53,429$0$12,764$0$20,148$0$419,507$0$45,254$0
ERIC M LOHN
REGIONAL CFO$84,493$0$18,463$0$58,225$0$10,285$0$4,372$0$175,838$0$0$0
GERRY G GILBERTSON
ADMINISTRATOR-MELROSE$167,944$0$40,332$0$49,952$0$41,761$0$8,722$0$308,711$0$29,981$0
DANIEL J SWENSON
ADMINISTRATOR-LONG PRAIRIE$182,093$0$42,165$0$16,214$0$28,825$0$23,623$0$292,920$0$14,312$0
DELANO A CHRISTANSON
ADMINISTRATOR - SAUK CENTRE$151,754$0$2,481$0$2,216$0$24,455$0$25,109$0$206,015$0$0$0
MARY E WELLS
ADMINISTRATOR - MONTICELLO$198,220$0$2,622$0$1,100$0$0$0$7,666$0$209,608$0$0$0
JOSEPH D HELLIE
VICE PRESIDENT$0$161,975$0$6,711$0$6,933$0$12,292$0$23,771$0$211,682$0$0
JOSEPH M BLONSKI MD
PHYSICIAN$271,276$0$8,062$0$8,033$0$18,967$0$21,626$0$327,964$0$0$0
MARK J LARKIN
VICE PRESIDENT OF DEVELOPMENT$219,072$0$51,326$0$13,779$0$39,434$0$29,074$0$352,685$0$11,571$0
MARY V PHIPPS
DIRECTOR$189,583$0$19,669$0$8,413$0$16,230$0$24,552$0$258,447$0$0$0
KEVIN R SWITZER
ASSOCIATE DIRECTOR$198,489$0$5,931$0$4,321$0$9,976$0$21,726$0$240,443$0$0$0
JIMMIE L BROWNING
ASSOCIATE DIRECTOR$200,835$0$5,281$0$792$0$0$0$1,068$0$207,976$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BTHE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO THE FORM 990, THE AMOUNTS LISTED IN SECTION VII AND IN SCHEDULE J REFLECT THIS TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON THE FORM 990. ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: TERENCE R PLADSON - PAID $225,588; ACCRUED $215,925 GREGORY R KLUGHERZ - PAID $84,515; ACCRUED $98,076 PAUL R HARRIS - PAID $67,504; ACCRUED $42,880 GERRY G GILBERTSON - PAID $29,981; ACCRUED $31,077 DANIEL J SWENSON - PAID $14,312; ACCRUED $18,188 MARK J LARKIN - PAID $11,571; ACCRUED $20,137 DELANO CHRISTIANSON - PAID $0; ACCRUED $12,563 JAMES R DAVIS - PAID $45,254; ACCRUED $0
PART I, LINE 6THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR CENTRACARE CLINIC OR CENTRACARE HEALTH SYSTEM; ACHIEVEMENT OF IMPROVEMENT IN PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; ACHIEVEMENT OF IMPROVEMENT IN OVERALL EMPLOYEMENT ENGAGEMENT SCORES; AND ACHIEVEMENT OF UP TO THREE INDIVIDUAL GOALS WHICH ARE TIED TO THE CENTRACARE SYSTEM'S STRATEGIC PLAN. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGEOF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE INCENTIVE COMPENSATION IS PAID.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
THE CITY OF ST CLOUD
A41600551578916VBB52009-08-10$201,078,369HEALTH CARE REVENUE BONDS 2008D000
THE CITY OF ST CLOUD
B41600551578916VBX72010-02-03$187,558,690HEALTH CARE REVENUE BONDS 2010AB000
THE CITY OF ST CLOUD
C4160055152011-12-28$10,000,000HEALTH CARE REVENUE BONDS 2011A000
THE CITY OF ST CLOUD
D4160055152011-12-28$31,445,000HEALTH CARE REVENUE BONDS 2011B000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndCapital ExpendituresCapitalExpendituresAmtUnspentUnspentAmtOther Spent ProceedsOtherSpentProceedsAmt
A$73,000,000$201,078,369$1,408,277$1,954,596$192,377,0622013Yes (1)0Yes (1)Yes (1)
B$187,558,690$11,776,763$2,076,6622010Yes (1)0Yes (1)Yes (1)
C$10,000,000$150,000000Yes (1)$8,916,874$933,126
D$31,445,0002012Yes (1)0Yes (1)Yes (1)$31,445,000

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndEngage Bond Counsel ResearchEngageBondCounselResearchIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)0Yes (1)Yes (1)0.000000.010000.0100000Yes (1)
B0Yes (1)0Yes (1)Yes (1)0.000000.021100.0211000Yes (1)
C000Yes (1)Yes (1)0.015000.000000.0150000Yes (1)
D000Yes (1)Yes (1)0.006900.000000.0069000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)Yes (1)000Yes (1)
B000Yes (1)0000Yes (1)
C0Yes (1)000000Yes (1)
D0Yes (1)00Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: THE CITY OF ST CLOUD DATE THE REBATE COMPUTATION WAS PERFORMED: 07/08/2014 ISSUER NAME: THE CITY OF ST CLOUD DATE THE REBATE COMPUTATION WAS PERFORMED: 06/20/2014ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1THE CITY OF ST CLOUDBusinessNameLine1
FieldValueIRS element (for citing)
Bond Issuer EIN416005515BondIssuerEIN
Bond Issued2012-09-19BondIssuedDt
Issue Price$64,885,000IssuePriceAmt
PurposeHEALTH CARE REVENUE BONDS 2012PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$64,885,000TotalProceedsAmt
Issuance Costs From Proceeds$3,500IssuanceCostsFromProceedsAmt
Substantial Completion2013SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease ArrangementsYes (1)AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research AgreementsYes (1)AnyResearchAgreementsInd
Engage Bond Counsel ResearchYes (1)EngageBondCounselResearchInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00400PrivateBusConcerningUBIPct
Total Private Business Use0.00400TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescNET ASSET CONDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$13,730,043NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2IN FY14 CENTRACARE HEALTH OPENED AN URGENT CARE CLINIC TO PROVIDE PATIENTS AN ALTERNATIVE TO GOING TO THE EMERGENCY ROOM. THIS CLINIC IS LOCATED AT THE PLAZA IN THE LOWER LEVEL.
FORM 990, PART VI, SECTION B, LINE 11ANNUALLY AT THE BOARD'S APRIL MEETING, PRIOR TO FILING WITH THE IRS, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW THE IRS FORM 990 WITH THE STAFF, TO ASK QUESTIONS AND SEEK CLARIFICATIONS, AND TO APPROVE THE FINAL DOCUMENT.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION AND BENEFITS OF THE PRESIDENT AND THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT REQUIRED BY LAW TO BE MADE AVAILABLE TO THE PUBLIC AND CENTRACARE HEALTH SYSTEM DOES NOT MAKE THEM AVAILABLE.
FORM 990, PART IX, LINE 11GMISCELLANEOUS: PROGRAM SERVICE EXPENSES 7,538,003. MANAGEMENT AND GENERAL EXPENSES 358,880. FUNDRAISING EXPENSES 7,211. TOTAL EXPENSES 7,904,094. CONTRACTED SERVICES/PURCH SVCS: PROGRAM SERVICE EXPENSES 9,890,741. MANAGEMENT AND GENERAL EXPENSES 1,134,662. FUNDRAISING EXPENSES 240,314. TOTAL EXPENSES 11,265,717.
FORM 990, PART XI, LINE 9:PENSION PLAN ADJUSTMENT -4,976. NET EQUITY TRANSFERS BTWN RELATED ORGS 10,162,028. OTHER CHANGES 204,316. DISTRIBUTIONS -1,000,000. NON-CONTROLLING INTEREST IN MONTICELLO CANCER CENTER 1,692,635.
FORM 990, PART I, LINE 6 - TOTAL NUMBER OF VOLUNTEERS:CENTRACARE HEALTH SYSTEM HAD 349 VOLUNTEERS IN FY14 THAT DONATED A TOTAL OF APPROXIMATELY 12,027 HOURS TO VARIOUS DEPARTMENTS. 119 OF THE VOLUNTEERS DONATED APPROXIMATELY 6,027 HOURS TO MONTICELLO HOSPITAL AND 230 VOLUNTEERS DONATED APPROXIMATELY 6,000 HOURS TO PAYNESVILLE HOSPITAL.
FORM 990, PAGE 1, LINE 11 "OTHER REVENUE"THE AMOUNT REPORTED ON LINE 11 OF PAGE 1, "OTHER REVENUE" IS $733,069 FOR THE CURRENT YEAR AND $2,543,184 FOR THE PRIOR YEAR. THE REASON FOR THE DIFFERENCE IS DUE TO A CHANGE IN REPORTING PRESENTATION. THE HEALTH INFO TECH INCENTIVE INCOME INCLUDED IN "ALL OTHER PROGRAM SERVICE REVENUE" ON LINE 2G OF THE STATEMENT OF REVENUE WAS REPORTED ON LINE 11 AS MISCELLANEOUS INCOME ON THE 2012 (FY13) FORM 990. THE INCOME OF THESE ACTIVITIES RELATES TO THE MISSION OF THE ORGANIZATION AND IS THE REASON FOR THE CHANGE IN PRESENTATION.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CENTRACARE SURGERY CENTER LLC
1406 6TH AVE NST CLOUDMN56303611514974SURGICAL CENTERMN$5,599,175$3,036,396CENTRACARE HEALTH SYSTEM
CENTRACARE HEALTH - MONTICELLO
1013 HART BLVDMONTICELLOMN55362461584944HEALTHCAREMN$64,702,555$63,412,530CENTRACARE HEALTH SYSTEM
CENTRACARE HEALTH - PAYNESVILLE
200 WEST FIRST STREETPAYNESVILLEMN56362433298651HEALTHCAREMN$41,302,289$31,848,291CENTRACARE HEALTH SYSTEM

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
ST CLOUD HOSPITAL
1406 6TH AVE NST CLOUDMN56303410695596ACUTE/LT CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH-MELROSE
11 NORTH 5TH AVE WESTMELROSEMN56352411865315ACUTE/LT CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH-LONG PRAIRIE
20 SE 9TH STREETLONG PRAIRIEMN56347411924645ACUTE/LT CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH-SAUK CENTRE
425 ELM STREET NORTHSAUK CENTREMN56378452438973ACUTE CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRAL MINNESOTA EMERGENCY PHYSICIANS
1406 6TH AVE NST CLOUDMN56303411708142EMERGENCY PHYSICIANSMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE CLINIC
1200 6TH AVE NORTHST CLOUDMN56303411806657MULTI-SPECIALTYMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH FOUNDATION
1406 6TH AVE NST CLOUDMN56303411855173FUNDRAISINGMN501(C)(3)LINE 7CENTRACARE HEALTH SYSTEMYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MONTICELLO CANCER CENTERBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 HART BLVD STE 50AddressLine1
CityMONTICELLOCity
StateMNState
ZIP Code55362ZIPCode
FieldValueIRS element (for citing)
EIN261909519EIN
Primary ActivitiesRADIATION & ONCOLOGY SERVICESPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CENTRACARE HEALTH SYSTEM - MONTICELLOBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$11,470,796ShareOfTotalIncomeAmt
Share Of EOY Assets$6,609,919ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.60000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CENTRACARE PHARMACY SERVICES INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11406 6TH AVE NAddressLine1
CityST CLOUDCity
StateMNState
ZIP Code56303ZIPCode
FieldValueIRS element (for citing)
EIN411620618EIN
Primary ActivitiesRETAIL PHARMACYPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CENTRACARE HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$2,411,073ShareOfTotalIncomeAmt
Share Of EOY Assets$3,658,154ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (22 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
CENTRACARE HEALTH SYSTEM - LONG PRAIRIE
A$137,381ARMS LENGTH
CENTRACARE HEALTH SYSTEM - MELROSE
A$111,131ARMS LENGTH
CENTRACARE PHARMACY SERVICES INC
A$122,118ARMS LENGTH
CENTRACARE CLINIC
A$3,925,109ARMS LENGTH
ST CLOUD HOSPITAL
A$16,162ARMS LENGTH
ST CLOUD HOSPITAL
O$464,902ARMS LENGTH
CENTRACARE CLINIC
O$450,347ARMS LENGTH
CENTRACARE CLINIC
P$7,129,294ARMS LENGTH
ST CLOUD HOSPITAL
P$1,532,580ARMS LENGTH
ST CLOUD HOSPITAL
Q$40,116,817ARMS LENGTH
CENTRACARE HEALTH SYSTEM - MELROSE
Q$287,284ARMS LENGTH
CENTRACARE HEALTH SYSTEM - LONG PRAIRIE
Q$303,621ARMS LENGTH
CENTRACARE HEALTH SYSTEM - SAUK CENTRE
Q$340,627ARMS LENGTH
CENTRACARE CLINIC
Q$7,138,207ARMS LENGTH
CENTRACARE FOUNDATION
Q$2,392,263ARMS LENGTH
CENTRACARE CLINIC
R$12,080,123ARMS LENGTH
CENTRACARE PHARMACY SERVICES INC
R$462,849ARMS LENGTH
ST CLOUD HOSPITAL
S$21,070,000ARMS LENGTH
CENTRACARE HEALTH SYSTEM - MELROSE
S$1,003,407ARMS LENGTH
CENTRACARE HEALTH SYSTEM - LONG PRAIRIE
S$831,252ARMS LENGTH
CENTRACARE HEALTH SYSTEM - MELROSE
D$1,947,912ARMS LENGTH
CENTRACARE HEALTH SYSTEM - LONG PRAIRIE
D$2,384,274ARMS LENGTH

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