CENTRACARE HEALTH SYSTEM-LONG PRAIRIE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CENTRACARE HEALTH SYSTEM-LONG PRAIRIE (EIN 41-1924645)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-07
- IRS object ID
- 201421279349301602
- Schema version
- 2012v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-07T14:01:14-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 NICOLLET MALL SUITE 1100 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411924645 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CENT | NameControl |
| Phone | 3207322141 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 SE NINTH STREET | AddressLine1 |
| City | LONG PRAIRIE | City |
| State | MN | State |
| ZIP Code | 56347 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CRAIG BROMAN | Name |
| Title | PRESIDENT | Title |
| Phone | 3207322141 | Phone |
| Date Signed | 2014-05-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TODD A JACKSON | Name |
| PTIN | P00092672 | PTIN |
| Phone | 6123324300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - LONG PRAIRIE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DR TERENCE PLADSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 SE NINTH STREET | AddressLine1 |
| City | LONG PRAIRIE | City |
| State | MN | State |
| ZIP Code | 56347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 26008072 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CENTRACARE.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | CENTRACARE HEALTH SYSTEM WORKS TO IMPROVE THE HEALTH OF EVERY PATIENT EVERY DAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 285 | TotalNbrEmployees |
| Total Nbr Volunteers | 200 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 33537 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 13191 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 23370646 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 24088775 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 375418 | InvestmentIncomePriorYear |
| Investment Income Current Year | 449291 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 292479 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1456815 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24072080 | TotalRevenuePriorYear |
| Total Revenue Current Year | 26008072 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 536745 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 50365 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 14844682 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 15476487 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8781926 | OtherExpensePriorYear |
| Other Expenses Current Year | 8573673 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 24163353 | TotalExpensesPriorYear |
| Total Expenses Current Year | 24100525 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -91273 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1907547 | RevenuesLessExpensesCY |
| Total Assets BOY | 19395442 | TotalAssetsBOY |
| Total Assets EOY | 20945664 | TotalAssetsEOY |
| Total Liabilities BOY | 5168512 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5416061 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14226930 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 15529603 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE QUALITY HEALTHCARE WITH COMPASSION, DIGNITY, INTEGRITY, AND RESPECT SHOWN TO ALL CUSTOMERS AND EMPLOYEES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16767913 | Expense |
| Grants | 50365 | Grants |
| Revenue | 25498150 | Revenue |
| Description | CCH - LONG PRAIRIE IS A 25 BED CRITICAL ACCESS HOSPITAL, CLINIC AND 70 BED LONG TERM CARE FACILITY LOCATED IN THE MIDDLE OF TODD COUNTY PROVIDING ACUTE CARE, DIAGNOSTIC, NURSING HOME AND CLINIC SERVICES. THE CCH - LONG PRAIRIE IS PART OF A LARGER INTEGRATED HEALTH CARE DELIVERY SYSTEM KNOWN AS CENTRACARE HEALTH, A SYSTEM RECOGNIZED FOR BEING A LEADER IN PROVIDING HIGH-QUALITY, COMPREHENSIVE CARE THROUGHOUT THE REGION. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CCH - LONG PRAIRIE PROVIDES ACUTE CARE SERVICES IN AREAS OF MEDICAL, SURGICAL AND OBSTETRICS ALONG WITH OTHER SERVICES OF EMERGENCY, IMAGING, LABORATORY, REHABILITATION, AND CHEMOTHERAPY. THIS HAS GENERATED CURRENT YEAR GROSS REVENUES OF $28,157,146 WITH EXPENSES OF $12,461,629. THERE WERE 620 INPATIENT VISITS, 2,451 INPATIENT DAYS WITH 17,973 OUTPATIENT VISITS. THE NURSING HOME GENERATED CURRENT YEAR GROSS REVENUES OF $3,990,119 AND EXPENSES OF $5,363,325. THERE WERE 22,782 RESIDENT DAYS. THE CLINIC SERVICES OF GENERAL SURGERY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ONCOLOGY, ORTHOPEDICS, AND UROLOGY GENERATED CURRENT YEAR GROSS REVENUES OF $5,391,497 AND EXPENSES OF $5,553,260. THERE WERE 13,400 CLINIC VISITS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 16767913 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 285 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LARRY KNUTSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3207327240 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 SOUTHEAST NINTH STREET | AddressLine1 |
| City | LONG PRAIRIE | City |
| State | MN | State |
| ZIP Code | 56347 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| TERENCE R PLADSON MD | ||||||||
| PRESIDENT | 1.00 | 53.00 | X | X | 0 | 1182844 | 200797 | |
| JAMES R DAVIS | ||||||||
| VICE PRESIDENT | 1.00 | 41.00 | X | X | 0 | 425311 | 37405 | |
| DAVID TILSTRA MD | ||||||||
| VICE PRESIDENT | 1.00 | 43.00 | X | X | 0 | 371398 | 56195 | |
| PAUL R HARRIS | ||||||||
| SECRETARY | 2.00 | 44.00 | X | X | 0 | 393819 | 76122 | |
| GREGORY R KLUGHERZ | ||||||||
| TREASURER | 1.00 | 45.00 | X | X | 0 | 605116 | 96478 | |
| ALLEN HORN MD | ||||||||
| DIRECTOR | 1.00 | 42.00 | X | 0 | 562765 | 37058 | ||
| DANIEL J SWENSON | ||||||||
| CEO | 40.00 | 0.50 | X | 0 | 233616 | 47352 | ||
| ERIC M LOHN | ||||||||
| REGIONAL CFO | 9.00 | 31.50 | X | 0 | 203554 | 24538 | ||
| JAMES M BERGMANN | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 162279 | 0 | 25816 | X | |||
| THOMAS J HOCK | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 153570 | 0 | 35316 | X | |||
| CHRISTOPHER A HAGEN | ||||||||
| PHARMACIST | 40.00 | 134010 | 0 | 23450 | X | |||
| MARK A CHRISTIANSEN | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 126418 | 0 | 14175 | X | |||
| CHRISTINE M OLSON | ||||||||
| NURSE PRACTIONER | 40.00 | 126186 | 0 | 21413 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 702463 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3978423 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 696115 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CENTRACARE CLINIC | |||||
| 1200 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | PHYSICIAN SERVICES | 1380539 |
| CENTRAL MINNESOTA DIAGNOSTIC INC | |||||
| 150 TENTH ST NW PO BOX 158 | MILACA | MN | 56353 | MOBILE MRI & CT SERVICES | 354019 |
| WEST CENTRAL ANESTESIA | |||||
| 10382 AUGUSTA DRIVE | SAUK CENTRE | MN | 56378 | CRNA SERVICES | 234635 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| All Other Contributions | 13191 | AllOtherContributions |
| Total Contributions | 13191 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT AND RESIDENT SERVICE REVE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 24088775 | TotalRevenueColumn |
| Related Or Exempt Function Income | 24088775 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 24088775 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 442087 | TotalRevenueColumn |
| Exclusion | $442,087 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 47440 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 47440 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 47440 | TotalRevenueColumn |
| Exclusion | $47,440 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7204 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7204 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7204 | TotalRevenueColumn |
| Exclusion | $7,204 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| QUALITY & TECH INITIATIVES | 900099 | 869810 | 869810 |
| SUPPLIES/DRUGS/FOOD SALES | 900099 | 253149 | 253149 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 286416 | TotalRevenueColumn |
| Related Or Exempt Function Income | 286416 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1409375 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26008072 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25498150 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $496,731 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50365 | Total |
| Program Services | 50365 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11081085 | Total |
| Program Services | 8282801 | ProgramServices |
| Management And General | 2798284 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 567779 | Total |
| Program Services | 418327 | ProgramServices |
| Management And General | 149452 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3127160 | Total |
| Program Services | 2287751 | ProgramServices |
| Management And General | 839409 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 700463 | Total |
| Program Services | 510717 | ProgramServices |
| Management And General | 189746 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54259 | Total |
| Program Services | 2397 | ProgramServices |
| Management And General | 51862 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79557 | Total |
| Management And General | 79557 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1776585 | Total |
| Program Services | 1477963 | ProgramServices |
| Management And General | 298622 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48624 | Total |
| Management And General | 48624 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 256742 | Total |
| Program Services | 141413 | ProgramServices |
| Management And General | 115329 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 369977 | Total |
| Program Services | 73618 | ProgramServices |
| Management And General | 296359 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 650257 | Total |
| Program Services | 348411 | ProgramServices |
| Management And General | 301846 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35799 | Total |
| Program Services | 22794 | ProgramServices |
| Management And General | 13005 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88612 | Total |
| Program Services | 55652 | ProgramServices |
| Management And General | 32960 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147186 | Total |
| Program Services | 405 | ProgramServices |
| Management And General | 146781 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117059 | Total |
| Management And General | 117059 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 761892 | Total |
| Management And General | 761892 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 144599 | Total |
| Program Services | 44046 | ProgramServices |
| Management And General | 100553 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 1842770 | 1805724 | 37046 |
| BAD DEBT | 694271 | 694271 | |
| MEDICAID SURCHARGE | 531386 | 22515 | 508871 |
| MINOR EQUIPMENT | 405844 | 297652 | 108192 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 568254 | Total |
| Program Services | 231091 | ProgramServices |
| Management And General | 337163 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24100525 | Total |
| Program Services | 16767913 | ProgramServices |
| Management And General | 7332612 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1788867 | BOY |
| EOY | 3281076 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3347382 | BOY |
| EOY | 3527708 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 312449 | BOY |
| EOY | 300224 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 173785 | BOY |
| EOY | 168171 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 15623920 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7993626 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7468332 | BOY |
| EOY | 7630294 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5554750 | BOY |
| EOY | 5255135 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 632363 | BOY |
| EOY | 496856 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117514 | BOY |
| EOY | 286200 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19395442 | BOY |
| EOY | 20945664 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1916671 | BOY |
| EOY | 2497266 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17021 | BOY |
| EOY | 15559 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6724 | BOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2535244 | BOY |
| EOY | 2461890 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 692852 | BOY |
| EOY | 441346 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5168512 | BOY |
| EOY | 5416061 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14203003 | BOY |
| EOY | 15502347 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23927 | BOY |
| EOY | 27256 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14226930 | BOY |
| EOY | 15529603 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19395442 | BOY |
| EOY | 20945664 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1907547 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 127626 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -732500 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
| Explanation In Part XIII | X | ExplanationInPartXIII |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 312427 | OtherCostOrOtherBasis |
| Book Value | 312427 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8781533 | OtherCostOrOtherBasis |
| Depreciation | 3649797 | Depreciation |
| Book Value | 5131736 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 279639 | OtherCostOrOtherBasis |
| Depreciation | 135636 | Depreciation |
| Book Value | 144003 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6250321 | OtherCostOrOtherBasis |
| Depreciation | 4208193 | Depreciation |
| Book Value | 2042128 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7630294 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSETS INTERNALLY DESIGNATED FOR CAPITAL ACQUISITIONS | Description |
| Book Value | 5255135 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 5255135 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| THIRD PARTY PAYOR SETTLEMENTS | $205,000 |
| ASSET RETIREMENT OBLIGATION | $107,939 |
| CAPITAL LEASES | $128,407 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 441346 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART IV, LINE 2B: | ReturnReference |
| Explanation | RESIDENT TRUST FUNDS ARE HELD BY THE ORGANIZATION ON BEHALF OF THE RESIDENTS IN A SEPARATE BANK ACCOUNT. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 175.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 303115 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 303115 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01300 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3518570 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2273928 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1244642 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05320 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3821685 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2273928 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1547757 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06620 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1516581 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1516581 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06480 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 326 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 326 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1516907 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1516907 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06480 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5338592 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2273928 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3064664 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13100 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $694,271 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 5745031 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5784361 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -39330 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LONG PRAIRIE | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 NINTH STRET SOUTHEAST | AddressLine1 |
| City | LONG PRAIRIE | City |
| State | MN | State |
| ZIP Code | 56347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | RURAL HEALTH CLINIC, NURSING HOME | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - LONG PRAIRIE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 175.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 250.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Lawsuit | X | Lawsuit |
| Other Actions | X | OtherActions |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LONG PRAIRIE CARE CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 NINTH STREET SE | AddressLine1 |
| City | LONG PRAIRIE | City |
| State | MN | State |
| ZIP Code | 56347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | NURSING HOME | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE ORGANIZATIONS TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX, AND THEIR COMMUNITY BENEFIT EXPENSE. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. | ||
| 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 2013 MEDICARE COST REPORT WAS USED TO DETERMINE ALLOWABLE COSTS. | ||
| PART III, LINE 9B: THE COLLECTION POLICIES AT CENTRACARE HEALTH - LONG PRAIRIE 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 REPROTED TO CREDIT RATING AGENCIES. | ||
| PART V, SECTION B, LINE 1J: CCHS 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 - LONG PRAIRIE | |
| PART 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 - LONG PRAIRIE | |
| PART 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 AND CENTRACARE HEALTH SAUK CENTRE.EACH HOSPITAL PREPARED INDIVIDUAL ACTION PLANS TO THE CHNA BASED ON SPECIFIC INPUT FROM THOSE COMMUNITIES. | CENTRACARE HEALTH - LONG PRAIRIE | |
| PART V, SECTION B, LINE 5C: 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 - LONG PRAIRIE | |
| PART V, SECTION B, LINE 6I: THE NEEDS IDENTIFIED BY THE CHNA ARE CURRENTLY IN ORGANIZATIONAL WORK PLANS AND ARE UNDER IMPLEMENTATION. | CENTRACARE HEALTH - LONG PRAIRIE | |
| PART V, SECTION B, LINE 7: PER GUIDANCE FROM THE IRS, (CITE), THE CHNA FOR CCH ELECTED NOT TO DIRECTLY ADDRESS SEVERAL DETERMINANTS OF HEALTH THAT IT IDENTIFIED IN ITS PROCESS WHICH WERE NOT WITHIN THE ORGANIZATIONS 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 - LONG PRAIRIE | |
| PART V, SECTION B, LINE 14G: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE CHARITY CARE INFORMATION EITHER VIA A TELEPHONE CALL OR A LETTER. | CENTRACARE HEALTH - LONG PRAIRIE | |
| PART 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 - LONG PRAIRIE | |
| PART V, SECTION B, LINE 17E: THE ORGANIZATION CONTRACTS WITH SEVERAL COLLECTION AGENCIES TO ATTEMPT TO COLLECT PATIENT BALANCES. | CENTRACARE HEALTH - LONG PRAIRIE | |
| PART V, SECTION B, LINE 18E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST THE PATIENT. | CENTRACARE HEALTH - LONG PRAIRIE | |
| PART 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 - LONG PRAIRIE | |
| PART VI, LINE 2: THE ORGANIZATION'S STRATEGIC PLANNING ASSESS THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, AND RECOMMENDATIONS FOR HEALTH CARE SERVICES. | ||
| PART VI, LINE 3: INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF LONG PRAIRIE'S 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: THE COMMUNITY OF LONG PRAIRIE AND THE SURROUNDING AREA CONSISTS OF APPROXIMATELY 25,000 PEOPLE. THE 2005 DEMOGRAPHIC INFORMATION INDICATES A SENIOR POPULATION (60 YEARS OR OLDER) OF 21% WHICH COMPARES TO 12.6% FOR THE ENTIRE STATE OF MINNESOTA. THE PER CAPITA INCOME OF THE RESIDENTS IN OUR AREA IS EXTREMELY DEPRESSED AT $20,696 COMPARED TO A STATE AVERAGE OF $33,322. AREA CONSISTS OF AGRICULTURE AND SOME INDUSTRY. | ||
| PART VI, LINE 5: THE FACILITY HAS A COMMUNITY BASED OPERATING COMMITTEE THAT MEETS ON A MONTHLY BASIS TO REVIEW VARIOUS ASPECTS OF THE FACILITY AND PROVIDE INPUT ON THOSE ASPECTS FROM A COMMUNITY PERSPECTIVE. THE FACILITY PARTICIPATES IN THE COMMUNITY BLOOD DRIVES BY PROVIDING FOOD AND SUPPLIES FOR BOTH THE WORKERS AND BLOOD DONORS. THE FACILITY ALSO SPONSORS A HEALTH FAIR ON AN ANNUAL BASIS FOR THE LOCAL AND SURROUNDING COMMUNITIES. | ||
| PART VI, LINE 6: THE ORGANIZATION IS 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. | ||
| MN | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVENUE NORTH | AddressLine1 |
| City | ST CLOUD | City |
| State | MN | State |
| ZIP Code | 56303 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 411855173 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 50000 | AmountOfCashGrant |
| Purpose Of Grant | SUPPORT FOUNDATION PROGRAMS | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TERENCE R PLADSON MD | ||||||||||||||
| PRESIDENT | 0 | 836543 | 0 | 335293 | 0 | 11008 | 0 | 177733 | 0 | 23064 | 0 | 1383641 | 0 | 0 |
| JAMES R DAVIS | ||||||||||||||
| VICE PRESIDENT | 0 | 285404 | 0 | 86006 | 0 | 53901 | 0 | 16180 | 0 | 21225 | 0 | 462716 | 0 | 0 |
| DAVID TILSTRA MD | ||||||||||||||
| VICE PRESIDENT | 0 | 258062 | 0 | 77615 | 0 | 35721 | 0 | 32861 | 0 | 23334 | 0 | 427593 | 0 | 15972 |
| PAUL R HARRIS | ||||||||||||||
| SECRETARY | 0 | 271402 | 0 | 73440 | 0 | 48977 | 0 | 39705 | 0 | 36417 | 0 | 469941 | 0 | 46361 |
| GREGORY R KLUGHERZ | ||||||||||||||
| TREASURER | 0 | 388446 | 0 | 120000 | 0 | 96670 | 0 | 77276 | 0 | 19202 | 0 | 701594 | 0 | 72702 |
| ALLEN HORN MD | ||||||||||||||
| DIRECTOR | 0 | 268622 | 0 | 145145 | 0 | 148998 | 0 | 18601 | 0 | 18457 | 0 | 599823 | 0 | 0 |
| DANIEL J SWENSON | ||||||||||||||
| CEO | 0 | 171115 | 0 | 45831 | 0 | 16670 | 0 | 22003 | 0 | 25349 | 0 | 280968 | 0 | 14863 |
| ERIC M LOHN | ||||||||||||||
| REGIONAL CFO | 0 | 161440 | 0 | 17969 | 0 | 24145 | 0 | 14681 | 0 | 9857 | 0 | 228092 | 0 | 0 |
| JAMES M BERGMANN | ||||||||||||||
| PHYSICIAN ASSISTANT | 153076 | 0 | 8382 | 0 | 821 | 0 | 12160 | 0 | 13656 | 0 | 188095 | 0 | 0 | 0 |
| THOMAS J HOCK | ||||||||||||||
| PHYSICIAN ASSISTANT | 145317 | 0 | 7840 | 0 | 413 | 0 | 11615 | 0 | 23701 | 0 | 188886 | 0 | 0 | 0 |
| CHRISTOPHER A HAGEN | ||||||||||||||
| PHARMACIST | 127986 | 0 | 5391 | 0 | 633 | 0 | 6829 | 0 | 16621 | 0 | 157460 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 3 | THE COMPENSATION PAID TO THE PRESIDENT AND VICE-PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME 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 FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: TERENCE R PLADSON - PAID $0; ACCRUED $158,983 JAMES R DAVIS - PAID $0; ACCRUED $0 DANIEL J SWENSON - PAID $14,863; ACCRUED $11,755 PAUL R HARRIS - PAID $46,361; ACCRUED $29,333 GREGORY R KLUGHERZ - PAID $72,702; ACCRUED $64,777 ALLEN HORN, MD - PAID $0; ACCRUED $0 DAVID TILSTRA, MD - PAID $15,972; ACCRUED $12,515 |
| PART I, LINE 6 | THE 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 EMPLOYMENT 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 PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE INCENTIVE COMPENSATION IS PAID. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CENTRACARE HEALTH SYSTEM, A MINNESOTA NONPROFIT ASSOCIATION, IS THE SOLE MEMBER OF CENTRACARE HEALTH SYSTEM - LONG PRAIRIE. | |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL BOARD MEMBERS ARE APPOINTED BY CENTRACARE HEALTH SYSTEM, THE SOLE MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING MATTERS ARE RESERVED FOR ACTION BY CENTRACARE HEALTH SYSTEM, THE SOLE MEMBER: 1. ADOPTION OR AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. 2. APPOINTMENT OF DIRECTORS AND OFFICERS. 3. APPROVAL OF THE CORPORTAION'S ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY DEBTS TO BE INCURRED. 4. APPROVAL OF ALL STRATEGIC PLANS. 5. DETERMINATION OF THE DISSOLUTION OF OR THE DISCONTINUATION OF THE BUSINESS OF THE CORPORATION. 6. APPROVAL OF ANY TRANSACTION WHICH MAY AFFECT THE CORPORATION'S STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | ANNUALLY, AT THE BOARD OF DIRECTORS' MEETING, PRIOR TO FILING, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW THE FORM 990 WITH STAFF TO ASK QUESTIONS AND SEEK CLARIFICATIONS AND TO APPROVE THE FINAL DOCUMENT. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE 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 QUESTIONNAIRE ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTE 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 15 | THE COMPENSATION AND BENEFITS OF THE PRESIDENT IS SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY ATHIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANTAND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE IN MAY 2012. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICALPROVIDERS) 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. THE MOST RECENT FULL REVIEW WAS DONE IN MAY 2012. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES DO AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. | |
| FORM 990, PART XI, LINE 9: | NET EQUITY TRANSFERS TO AFFILIATED ORGANIZATIONS -856,000. OTHER CHANGES IN NET ASSETS 123,500. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HEALTH SYSTEM | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411813221 | HEALTH CARE | MN | 501(C)(3) | 11 - TYPE 3 FI | N/A | 0 | |
| CENTRACARE HEALTH SYSTEM-MELROSE | |||||||||||
| 11 NORTH 5TH AVENUE WEST | MELROSE | MN | 56352 | 411865315 | ACUTE & LT CARE | MN | 501(C)(3) | LINE 3 | 1 | CENTRACARE HEALTH SYSTEM | |
| CENTRAL MINNESOTA EMERGENCY PHYSICIANS | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411708142 | EMERGENCY PHYS | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE CLINIC | |||||||||||
| 1200 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411806657 | MULTI-SPECIALTY | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH FOUNDATION | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411855173 | FUNDRAISING | MN | 501(C)(3) | LINE 7 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH-SAUK CENTRE | |||||||||||
| 425 ELM STREET NORTH | SAUK CENTRE | MN | 56378 | 452438973 | ACUTE CARE | MN | 501(C)(3) | LINE 3 | 1 | CENTRACARE HEALTH SYSTEM | |
| ST CLOUD HOSPITAL | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 410695596 | ACUTE & LONG TERM CARE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE PHARMACY SERVICES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVE NORTH | AddressLine1 |
| City | ST CLOUD | City |
| State | MN | State |
| ZIP Code | 56303 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411620618 | EIN |
| Primary Activity | RETAIL PHARMACY | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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