LIFECARE MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- LIFECARE MEDICAL CENTER (EIN 41-1804205)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-05
- IRS object ID
- 201432179349300243
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-05T13:16:05-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 554027033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411804205 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LifeCare Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LIFE | NameControl |
| Phone | 2184632500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Delmore Drive | AddressLine1 |
| City | Roseau | City |
| State | MN | State |
| ZIP Code | 56751 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Keith Okeson | Name |
| Title | CEO/President | Title |
| Phone | 2184632500 | Phone |
| Date Signed | 2014-08-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Sarah Vogt CPA | Name |
| PTIN | P00978242 | PTIN |
| Phone | 6122536500 | Phone |
| Date Prepared | 2014-07-21 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Keith Okeson | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Delmore Drive | AddressLine1 |
| City | Roseau | City |
| State | MN | State |
| ZIP Code | 56751 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 40295289 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.lifecaremedicalcenter.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | Promotion of Health | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 523 | TotalNbrEmployees |
| Total Nbr Volunteers | 358 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 288699 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 208904 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 38055024 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 39656659 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 236682 | InvestmentIncomePriorYear |
| Investment Income Current Year | 235227 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 22399 | OtherRevenuePriorYear |
| Other Revenue Current Year | -50354 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 38602804 | TotalRevenuePriorYear |
| Total Revenue Current Year | 40050436 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 24794 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20253706 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20433065 | 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 | 14128804 | OtherExpensePriorYear |
| Other Expenses Current Year | 15556487 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 34384010 | TotalExpensesPriorYear |
| Total Expenses Current Year | 36014346 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4218794 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4036090 | RevenuesLessExpensesCY |
| Total Assets BOY | 57235217 | TotalAssetsBOY |
| Total Assets EOY | 60958197 | TotalAssetsEOY |
| Total Liabilities BOY | 10999573 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10766478 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 46235644 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 50191719 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide care for a healthy life. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 31133591 | Expense |
| Grants | 24794 | Grants |
| Revenue | 39656659 | Revenue |
| Description | LifeCare Medical Center operates a 25-bed acute care hospital, including a 60-bed nursing facility, home health, hospice, and public health in Roseau, Minnesota. The organization also operates a 40-bed nursing home and 12 apartments of assisted living in Greenbush, Minnesota. The purpose of the organization is to own, maintain, and operate a hospital, nursing homes, furnish medical and surgical care to the sick, infirmed, or injured.Acute Care Hospital (Inpatient and Outpatient)Inpatient days: 2,128Outpatient visits: 35,878Long Term CareLifeCare Roseau Manor Resident Days: 19,697LifeCare Greenbush Manor Resident Days: 14,350Home Health/Public Health Visits: 12,441Hospice Clients Served: 21To fulfill its mission of community service, LifeCare Medical Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. The amount of charges foregone, based on established rates, was $598,019 for the year ended September 30, 2013. | Description |
| Total Program Service Expense | 31133591 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 72 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 523 | 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 0 | InvestmentInJointVenture |
| 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 | Cathy Huss | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2184634763 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Delmore Drive | AddressLine1 |
| City | Roseau | City |
| State | MN | State |
| ZIP Code | 56751 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Corwin Vatnsdal | |||||||
| Chair | 1.00 | X | X | 2475 | 0 | 0 | |
| Carolyn Eeg | |||||||
| Vice Chair | 1.00 | X | X | 1200 | 0 | 0 | |
| Carmen Przekwas | |||||||
| Secretary | 1.00 | X | X | 1800 | 0 | 0 | |
| Therese McBride | |||||||
| Treasurer | 1.00 | X | X | 1500 | 0 | 0 | |
| Brenda Sather | |||||||
| Trustee | 1.00 | X | 1200 | 0 | 0 | ||
| Ralph Herseth MD | |||||||
| Trustee | 1.00 | X | 1050 | 0 | 0 | ||
| Paul Everson | |||||||
| Trustee | 1.00 | X | 600 | 0 | 0 | ||
| Mark Wilson | |||||||
| Trustee | 1.00 | X | 1125 | 0 | 0 | ||
| Pete Granger | |||||||
| Trustee | 1.00 | X | 675 | 0 | 0 | ||
| Steve Haugen | |||||||
| Trustee | 1.00 | X | 675 | 0 | 0 | ||
| Pete Helgeson | |||||||
| Trustee | 1.00 | X | 750 | 0 | 0 | ||
| Chuck Lindner | |||||||
| Trustee | 1.00 | X | 975 | 0 | 0 | ||
| Shayne Isane | |||||||
| Trustee | 1.00 | X | 600 | 0 | 0 | ||
| Keith Okeson | |||||||
| CEO/President | 40.00 | X | 210269 | 0 | 36326 | ||
| Cathy Huss | |||||||
| CFO | 40.00 | X | 160997 | 0 | 29493 | ||
| Gordon Streiff | |||||||
| Pharmacy Director | 40.00 | 130412 | 0 | 28977 | X | ||
| Susan Lisell | |||||||
| Senior Leader | 40.00 | 148355 | 0 | 20820 | X | ||
| Shannon D Carlson | |||||||
| Senior Leader | 40.00 | 110304 | 0 | 23879 | X | ||
| Judy K Mattson | |||||||
| Pharmacist | 40.00 | 121901 | 0 | 28857 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 896863 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 168352 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Wapiti Medical Group | |||||
| PO Box 92 | Newell | SD | 57760 | Locum Physicians | 1227012 |
| Comstock Construction Inc of Minnesota | |||||
| 1003 Progress Dr | Fergus Falls | MN | 56537 | Construction | 1215194 |
| Central Minnesota Diagnostic | |||||
| 150 10th St NW | Milaca | MN | 56353 | Medical | 520500 |
| R C Shefland Anesthesia Ltd | |||||
| 27040 COUNTY 9 | Bemidji | MN | 566019005 | Medical | 417581 |
| Shared Medical Technologies Inc | |||||
| 202 West Newton Street | Rice Lake | WI | 54868 | Medical | 284356 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Government Grants | 83008 | GovernmentGrants |
| All Other Contributions | 125896 | AllOtherContributions |
| Total Contributions | 208904 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Service Revenue | 622110 | 38299474 | 38299474 |
| Other Revenue | 621500 | 1357185 | 1357185 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 39656659 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 251362 | TotalRevenueColumn |
| Exclusion | $251,362 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 287630 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 228718 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 58912 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 58912 | TotalRevenueColumn |
| Exclusion | $58,912 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 16135 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -16135 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -16135 | TotalRevenueColumn |
| Exclusion | -$16,135 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Loss on Refinancing | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | -109266 | TotalRevenueColumn |
| Exclusion | -$109,266 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -109266 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40050436 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39656659 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $184,873 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20690 | Total |
| Program Services | 20690 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4104 | Total |
| Program Services | 4104 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 489779 | Total |
| Management And General | 489779 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15509723 | Total |
| Program Services | 13474475 | ProgramServices |
| Management And General | 2035248 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 541560 | Total |
| Program Services | 494197 | ProgramServices |
| Management And General | 47363 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2751557 | Total |
| Program Services | 2417386 | ProgramServices |
| Management And General | 334171 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1140446 | Total |
| Program Services | 963971 | ProgramServices |
| Management And General | 176475 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21664 | Total |
| Management And General | 21664 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60873 | Total |
| Management And General | 60873 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4152074 | Total |
| Program Services | 3911198 | ProgramServices |
| Management And General | 240876 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168920 | Total |
| Management And General | 168920 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1998282 | Total |
| Program Services | 1056775 | ProgramServices |
| Management And General | 941507 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 776800 | Total |
| Program Services | 768647 | ProgramServices |
| Management And General | 8153 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 339758 | Total |
| Program Services | 324779 | ProgramServices |
| Management And General | 14979 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53659 | Total |
| Program Services | 18702 | ProgramServices |
| Management And General | 34957 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 149465 | Total |
| Program Services | 149465 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2489717 | Total |
| Program Services | 2489717 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132910 | Total |
| Program Services | 132910 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Medical Supplies | 3139183 | 3139183 |
| Bad Debt Expense | 695915 | 695915 |
| Surcharge Fees | 576570 | 576570 |
| MN Care Tax | 439265 | 439265 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 361432 | Total |
| Program Services | 55642 | ProgramServices |
| Management And General | 305790 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36014346 | Total |
| Program Services | 31133591 | ProgramServices |
| Management And General | 4880755 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7046473 | BOY |
| EOY | 5434503 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5804454 | BOY |
| EOY | 5812017 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 627781 | BOY |
| EOY | 780947 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135072 | BOY |
| EOY | 162034 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 46570960 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 22432879 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21649197 | BOY |
| EOY | 24138081 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19495457 | BOY |
| EOY | 22844729 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 851536 | BOY |
| EOY | 856473 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1625247 | BOY |
| EOY | 929413 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57235217 | BOY |
| EOY | 60958197 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4181237 | BOY |
| EOY | 4591350 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 725000 | BOY |
| EOY | 501000 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5870000 | BOY |
| EOY | 5440000 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 223336 | BOY |
| EOY | 234128 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10999573 | BOY |
| EOY | 10766478 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46235644 | BOY |
| EOY | 50191719 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46235644 | BOY |
| EOY | 50191719 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57235217 | BOY |
| EOY | 60958197 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 4036090 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -80015 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | 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 Separate | X | FinancialStatementSeparate |
| 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 B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
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 | 15740 | OtherCostOrOtherBasis |
| Book Value | 15740 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31767536 | OtherCostOrOtherBasis |
| Depreciation | 13484975 | Depreciation |
| Book Value | 18282561 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12836294 | OtherCostOrOtherBasis |
| Depreciation | 8446524 | Depreciation |
| Book Value | 4389770 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1951390 | OtherCostOrOtherBasis |
| Depreciation | 501380 | Depreciation |
| Book Value | 1450010 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 24138081 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 39482534 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -80015 | NetUnrealizedGainsInvestments |
| Other Revenues | -716605 | OtherRevenues |
| Revenue Not Rptd F990 | -796620 | RevenueNotRptdF990 |
| Revenue Subtotal | 40279154 | RevenueSubtotal |
| Other Revenues Not Included | -228718 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -228718 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 40050436 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35526459 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 228718 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 228718 | ExpensesNotRptdF990 |
| Expenses Subtotal | 35297741 | ExpensesSubtotal |
| Other Expenses Not Included | 716605 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 716605 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 36014346 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part IV, Line 2b: | The Medical Center acts as custodian for the funds of the residents, holds resident security deposits, and holds employee voluntary withholdings. Funds for residents and others totaled $234,128 and $223,336 at September 30, 2013 and 2012. | |
| Part X, Line 2: | The Medical Center is organized as a Minnesota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Medical Center is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. The Medical Center files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Medical Center believes that is has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The Medical Center's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2009. | Description of Uncertain Tax Positions Under FIN 48: |
| Provision for Bad Debts -695,915. Contribution Expense Recorded in Revenue for Financial Statements -20,690. | Part XI, Line 2d - Other Adjustments: | |
| Rental Expense Recorded in Expense for Financial Statements -228,718. | Part XI, Line 4b - Other Adjustments: | |
| Rental Expense Recorded in Expense for Financial Statements 228,718. | Part XII, Line 2d - Other Adjustments: | |
| Provision for Bad Debts 695,915. Contribution Expense Recorded in Revenue for Financial Statements 20,690. | Part XII, Line 4b - Other Adjustments: |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| 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 | 394000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 394000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01120 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7124859 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5633230 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1491629 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04220 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7518859 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5633230 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1885629 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05340 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 176490 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 176490 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 165347 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 165347 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00470 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3326807 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2265768 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1061039 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 55727 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 55727 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3724371 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2265768 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1458603 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04130 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11243230 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7898998 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3344232 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09470 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2034 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2034 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 7453 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7453 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 13790 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 13790 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6815 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6815 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 73809 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 73809 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 21266 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 21266 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 125167 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 125167 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $695,915 | BadDebtExpenseAmount |
| Amount Attributable To | 9365 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6010052 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6016942 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -6890 | 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 | LifeCare Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Delmore Drive | AddressLine1 |
| City | Roseau | City |
| State | MN | State |
| ZIP Code | 56751 | 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 |
| Er Other | X | ErOther |
| Other | Urgent Care | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LifeCare Medical Center | 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 |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| 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 | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| LifeCare Roseau Manor | ||||
| 715 Delmore Drive | Roseau | MN | 56751 | Skilled Nursing Facility |
| LifeCare Greenbush Manor | ||||
| 19120 290th Street | Greenbush | MN | 56726 | Skilled Nursing Facility and Assisted Living Facility |
| LifeCare Home Care and Hospice | ||||
| 715 Delmore Drive | Roseau | MN | 56751 | Home Health and Hospice |
Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 3c: Part I, Line 6b: The organization's community benefit report can be found on its website at lifecaremedicalcenter.org and is shared with service area residents in an annual newsletter that focuses on community benefit. | ||
| Part I, Line 7: Charity care was converted to cost by multiplying the ratio of cost to gross charges by the gross uncompensated charges associated with providing charity care to its patients. Community health improvements and cash and in-kind contributions are calculated at actual costs recorded in the general ledger. Education costs are based on estimated time and wages to manage students and interns at the facilities. Medicaid is calculated based on gross charges and estimated payments from the internal revenue system. Subsidized health services is converted to cost according to costs allocated to the relevant cost centers on the Medicare Cost Report. | ||
| Part I, L7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $695,915. | ||
| Part II: Economic development and community support includes donations to local community organizations and employee staff time donated to local community committees. Environmental improvements include the time employees spend in their involvement in the Green Team. Employees of the Green Team managed the process for creating other recycling opportunities for its employees that would not otherwise be available to the them. Employees have also been included in a Healing Garden Team that has developed a tranquil park area for use by our patients, families, employees and community. We also had an asbestos removal project. Coalition building includes EMT training for area First Responders and Fire Departments, as well as time donated to the Roseau Area Diabetes Center.Community health improvement advocacy includes staff time on healtcare related boards that advocate for healthcare, as well as time spent on discussions on proper prescription drug disposals, med alerts, chronic disease management, time spent in local correctional facilities on prescription drug abuse and on the Roseau County Committee on Aging.By being involved in the community through the above activities, we are able to increase health awareness.Roseau County is considered a Health Professional Shortage Area and therefore is including the costs of recruitment in workforce development. This promotes better care for our patients. | ||
| Part III, Line 4: The estimated amount of bad debt expense attributable to patients eligible under the organization's charity care policy is calculated by using gross charity care at charges as a percentage of total gross hospital revenue. It is reasonable to assume that charity care as a percentage of gross revenue can also be applied to bad debt.Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Financial Statement Note:The footnote that describes bad debt expense can be found on page seven and eight of the audited financial statement. | ||
| Part III, Line 8: Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. | ||
| Part III, Line 9b: If a patient is known to qualify for financial assistance, or if the patient begins the financial assistance process, all collection actions cease until the application is completed. | ||
| Part V, Section B, Line 3: Representatives from both LifeCare Medical Center and LifeCare Public Health conducted 13 individual meetings with organizations and individuals who represent all geographic and age levels in our service area. These included: Roseau Ministerial Association, Warroad School District, Roseau School District, Badger/Greenbush School District, Warroad Chamber of Commerce, Altru Physicians, Marvin Windows and Doors, Central Boiler and Polaris Industries (3 largest employers in service area). In addition, those who serve low-income and minority populations were represented by Roseau County Social Services, LifeCare Public Health, Northwest Community Action and HeadStart. | LifeCare Medical Center | |
| Part V, Section B, Line 4: The CHNA was mailed to all city offices, county leadership and those who participated in the needs assessment. | LifeCare Medical Center | |
| Part V, Section B, Line 5c: The CHNA was made available at www.lifecaremedicalcenter.org.The CHNA was mailed to all city offices, county leadership and those who participated in the needs assessment. | LifeCare Medical Center | |
| Part V, Section B, Line 6i: The Implementation Strategy was made available upon request. | LifeCare Medical Center | |
| Part V, Section B, Line 7: We did not address the need for positive parenting. LifeCare Medical Center does not have the expertise to implement strategies for this area of concern, but we do have related programs to help new parents navigate the first few years of their baby's life through services offered in our LifeCare Public Health department. Additionally, we will support those organizations who can make an impact by offering education in topics such as exercise, nutrition, and health overall well-being. | LifeCare Medical Center | |
| Part V, Section B, Line 14g: In addition to providing the full policy upon request, the Hospital also summarizes the policy on its website, billing invoices, as well as brochures summarizing the policy in the emergency rooms and admissions office. | LifeCare Medical Center | |
| Part VI, Line 2: LifeCare provides the Public Health functions for the Roseau County. Through this role, we participated in a community needs assessment through Quinn County to assess the needs of our service area. | ||
| Part VI, Line 3: We have financial counselors who have phone conversations with patients during our collections process. We guide patients to other financial programs as well as our own charity care program. Brochures are available in the admitting area which is in the same location as the Emergency Room. Information is also sent to our patients via patient bills. Our website has the charity care application and brochure, as well as the contact information for our financial counselors, available to patients. | ||
| Part VI, Line 4: Roseau County is a rural area with a population of approximately 17,000 people. We are the sole hospital located in Roseau County and the nearest tertiary hospital is two hours away. We are a federally-designated medically underserved area. In 2009, approximately 12.7% of the population was age 65 or older. The average per capita income is 23,061 and approximately 9.7% of the population is below the federal poverty level. | ||
| Part VI, Line 5: The organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay.As a not-for-profit organization, LifeCare Medical Center has made a promise to give back to its community. As a regional healthcare leader, LifeCare strives to respond to healthcare needs by partnering with local leaders, educators, government officials and others.The community benefit report summarizes how this leadership role has made a difference to the people of the area. Included are highlights describing how LifeCare has played an integral role in enhancing the health and overall well being of the community.Trusted PartnershipsLifeCare's commitment to quality care extends beyond its walls and into the community where strong partnerships have been built to maintain and improve the health and overall well-being of its neighbors. LifeCare EMS personnel are proud of their trusted relationships with regional emergency response groups. Area fire fighters, police, and others participate in disaster training sessions where a disaster is staged and responded to as if it were a real life situation. This type of training helps prepare all groups involved.Education for a Healthy FuturePart of LifeCare's mission is to help educate the next generation of health care professionals. LifeCare Directors work closely with many regional high school and post-secondary educational facilities to bring students into our organization through job shadowing, internships, rural scholar and other programs. Through these programs, students get a firsthand look at specific health care careers as they learn from our staff for a day, week, month or several months based on their program. Students often times focus on rural healthcare employment opportunities that may be available to them once they have completed their education.Community CareLifeCare recognizes that circumstances arise where a patient is simply unable to pay a hospital bill. In these situations, LifeCare offers a program called Community Care, in which LifeCare forgives the bills of deserving families and individuals who meet set income guidelines. Great appreciation has been voiced by many who received a helping hand from this program. In fiscal year 2013, LifeCare granted nearly $600,000 in Community Care based on charges foregone.A Healthy Awareness and Community OutreachLifeCare employees know the importance of educating the public about a healthy lifestyle. And sometimes the best way to provide awareness is to venture outside the facility. That's why LifeCare is involved with many initiatives throughout our communities. By reaching out to the public through parish nursing, nutrition and exercise programs, civic projects, health and safety awareness, health fairs, and other methods, they are able to educate and strengthen the community.Fifth grade tours have become a favorite for students throughout Roseau County. A hospital tour is coupled with a mini health fair where students learn their blood type. The goal of this program is to influence young students into making healthy lifestyle decisions, in addition to introducing them to careers in healthcare.A partnership with area law enforcement has allowed LifeCare to initiate the POLST program, which assists local and county law enforcement officers and other first responders in helping patients in a medical emergency.Funding Essential ServicesLifeCare's commitment to community needs is exemplified by its contribution to subsidized services. In fiscal year 2013, LifeCare absorbed approximately $1,000,000 in costs in order to sustain services that rely on funding from other sources, in particular the Medicaid program. These departments include Home Health Care, Hospice, Public Health, and LifeCare's two nursing homes (Roseau Manor and Greenbush Manor).LifeCare Medical Center distributed almost $3.9 million in Community Benefits in fiscal year 2013. | ||
| MN | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|
| District 682 Roseau Public Schools | ||||||
| 509 3rd Street | Roseau | MN | 56751 | City of Roseau | 6385 | Concussion prevention |
| District 690 Warroad Public Schools | ||||||
| 510 Cedar Ave NW | Warroad | MN | 56763 | City of Warroad | 6300 | Concussion prevention |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The Medical Center does not monitor the donations to the schools as they were not grants that had any requirements. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | 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 | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Keith Okeson | ||||||||||||||
| CEO/President | 199252 | 0 | 9480 | 0 | 1537 | 0 | 14472 | 0 | 23543 | 0 | 248284 | 0 | 0 | 0 |
| Cathy Huss | ||||||||||||||
| CFO | 149718 | 0 | 10001 | 0 | 1278 | 0 | 10339 | 0 | 20668 | 0 | 192004 | 0 | 0 | 0 |
| Gordon Streiff | ||||||||||||||
| Pharmacy Director | 128998 | 0 | 250 | 0 | 1164 | 0 | 8724 | 0 | 21596 | 0 | 160732 | 0 | 0 | 0 |
| Susan Lisell | ||||||||||||||
| Senior Leader | 140030 | 0 | 5900 | 0 | 2425 | 0 | 9233 | 0 | 12969 | 0 | 170557 | 0 | 0 | 0 |
| Judy K Mattson | ||||||||||||||
| Pharmacist | 120737 | 0 | 25 | 0 | 1139 | 0 | 8103 | 0 | 21773 | 0 | 151777 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Roseau Area Hospital District | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 410785143 | IssuerEIN |
| CUSIP Number | 777187CW3 | CUSIPNumber |
| Date Issued | 2012-11-15 | DateIssued |
| Issue Price | 5860000 | IssuePrice |
| Description Of Purpose | Refund Series 1998 Bonds Issued 12/01/1998 | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | 5860000 | TotalProceeds |
| Amount In Reserve Fund | 586000 | AmountInReserveFund |
| Issuance Costs From Proceeds | 117200 | IssuanceCostsFromProceeds |
| Other Spent Proceeds | 5156800 | OtherSpentProceeds |
| Year Of Subst Completion | 2012 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 1 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 1 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule K, Part II, Line 4, Gross Proceeds in Reserve Fund | Identifier |
| Explanation | The filing organization does not report the $586,000 reserve funds on the their audited financials due to the issuer of the tax exempt bonds holding these funds. The issuer of the tax exempt bonds has included this amount on their financial statements. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 1 | The Executive Committee consists of the Chair, Vice-Chair, Treasurer, Secretary, and at least one other director (who shall be selected annually.) The President/CEO will be a non-voting member of the committee. The President/CEO will be excused for matters relating to compensation and evaluation. The Executive Committee shall meet as often as necessary at the call of the Chair, Vice-Chair, or at the request of any two of its members. A majority of the Executive Committee shall constitute a quorum. The Executive Committee's specific responsibilities are to: * Exercise the authority of the board in the management of the business of the corporation between regularly scheduled meetings. * Report to the board any official actions it has taken at the next board meeting. * Review and approve the compensation program for the senior leaders of the organization that is designed to allow the organization to recruit and retain superior talent. * Responsible for conducting on an annual basis the process of establishing goals, evaluating the performance and establishing the compensation of the President/CEO. | |
| Form 990, Part VI, Section B, line 11 | The return is reviewed initially by the CFO. The return is made available to the Board of Trustees before it is filed. | |
| Form 990, Part VI, Section B, line 12c | All officers, trustees, and key employees are required to complete a conflict of interest form annually. The form is reviewed by the Board of Trustees to determine if any conflicts exist. If there are any conflicts, the Board of Trustees will discuss the restrictions that should be placed on the person with the conflict. Restrictions are typically related to voting and discussion of matters related to the conflict. | |
| Form 990, Part VI, Section B, line 15 | The compensation for the CEO and CFO is approved by the Executive Committee based on comparability data. The CEO and CFO both have employment contracts. The deliberation and discussion of compensation is documented in the board meeting minutes. This process takes place on an annual basis. | |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy, and financial statements are available upon request. | |
| Form 990, Part IX, line 11g | Physician Fees: Program service expenses 1,567,955. Management and general expenses 38,460. Fundraising expenses 0. Total expenses 1,606,415. Service Related Fees: Program service expenses 2,146,981. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,146,981. Other Professional Fees: Program service expenses 196,262. Management and general expenses 202,416. Fundraising expenses 0. Total expenses 398,678. | Other Fees |