CENTRACARE HEALTH SYSTEM-LONG PRAIRIE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CENTRACARE HEALTH SYSTEM-LONG PRAIRIE (EIN 41-1924645)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201331349349300913
- Schema version
- 2011v1.5
- 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 | 2013-05-14T09:56:52-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | 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 | 2011-07-01 | 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 | ERIC LOHN | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 3207322141 | Phone |
| Date Signed | 2013-05-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KOREY BOELTER | Name |
| PTIN | P00775161 | PTIN |
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES DAVIS | 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 | 24078203 | 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 | TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 286 | TotalNbrEmployees |
| Total Nbr Volunteers | 75 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 28517 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 33537 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 23797199 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 23370646 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 445085 | InvestmentIncomePriorYear |
| Investment Income Current Year | 375418 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 191354 | OtherRevenuePriorYear |
| Other Revenue Current Year | 292479 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24462155 | TotalRevenuePriorYear |
| Total Revenue Current Year | 24072080 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 204802 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 536745 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 14268532 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 14844682 | 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 | 9059965 | OtherExpensePriorYear |
| Other Expenses Current Year | 8781926 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 23533299 | TotalExpensesPriorYear |
| Total Expenses Current Year | 24163353 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 928856 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -91273 | RevenuesLessExpensesCY |
| Total Assets BOY | 19640698 | TotalAssetsBOY |
| Total Assets EOY | 19395442 | TotalAssetsEOY |
| Total Liabilities BOY | 5077823 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5168512 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14562875 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14226930 | NetAssetsOrFundBalancesEOY |
| Mission Description | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE PROVIDES QUALITY HEALTH CARE WITH COMPASSION, DIGNITY, INTEGRITY, AND RESPECT SHOWN TO ALL CUSTOMERS AND EMPLOYEES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16936197 | Expense |
| Grants | 536745 | Grants |
| Revenue | 23370646 | Revenue |
| Description | THE ORGANIZATION IS DEDICATED TO THE CONCEPT OF PROVIDING RESIDENTS OF LONG PRAIRIE AND THE SURROUNDING AREA WITH QUALITY HEALTH CARE FOR INPATIENT, OUTPATIENT, EMERGENCY CARE, AND NURSING HOME CARE. THE ORGANIZATION PROVIDED $2,618,764 OF COMMUNITY BENEFIT AND CONTRIBUTIONS DURING THE YEAR THROUGH HOSPITAL SERVICES, A HEALTH FAIR, A BLOODMOBILE AND OTHER ACTIVITIES. | Description |
| Total Program Service Expense | 16936197 | 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 | 1 | 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 | 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 | 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 | 0 | 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 |
| Number Of Employees | 286 | 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 | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LARRY KNUTSON | NamePerson |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| JAMES DAVIS | ||||||||
| DIRECTOR/VP OPERATIONS OF CCHS | 1.00 | X | 0 | 380588 | 36682 | |||
| ALLEN HORN MD | ||||||||
| DIRECTOR/CEO OF CCC | 1.00 | X | 0 | 587816 | 114083 | |||
| GREGORY KLUGHERZ | ||||||||
| DIRECTOR/CFO OF CCHS | 1.00 | X | 0 | 524194 | 106835 | |||
| TERENCE PLADSON MD | ||||||||
| DIRECTOR/CEO OF CCHS | 1.00 | X | 0 | 948477 | 213721 | |||
| PAUL HARRIS | ||||||||
| DIRECTOR/VP & GEN. COUNSEL OF CCHS | 1.00 | X | 0 | 307893 | 83406 | |||
| DANIEL SWENSON | ||||||||
| CEO | 40.00 | 0 | 216883 | 48786 | X | |||
| ERIC LOHN | ||||||||
| CFO | 13.00 | 0 | 189382 | 22576 | X | |||
| JAMES BERGMANN | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 167161 | 0 | 26805 | X | |||
| THOMAS HOCK | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 146234 | 0 | 35883 | X | |||
| MARK CHRISTIANSEN | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 134193 | 0 | 12491 | X | |||
| CHRISTOPHER HAGEN | ||||||||
| PHARMACY MANAGER | 40.00 | 123017 | 0 | 25561 | X | |||
| CHRISTINE OLSON | ||||||||
| NURSE PRACTICIONER | 40.00 | 115904 | 0 | 19703 | X | |||
| JOHN SECKINGER | ||||||||
| DIRECTOR | 0.00 | 0 | 283393 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 686509 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3438626 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 746532 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 | 1766619 |
| CENTRACARE HEALTH SYSTEM - MELROSE | |||||
| 11 NORTH 5TH AVENUE WEST | MELROSE | MN | 56352 | BILLING SERVICES | 322070 |
| WEST CENTRAL ANESTHESIA PC | |||||
| 10382 AUGUSTA DRIVE | SAUK CENTRE | MN | 56378 | CRNA SERVICES | 232239 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Government Grants | 32866 | GovernmentGrants |
| All Other Contributions | 671 | AllOtherContributions |
| Total Contributions | 33537 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUES | 621110 | 22973496 | 22973496 |
| JOINT VENTURE REVENUES | 621110 | 216653 | 216653 |
| PHARMACY INCOME | 621110 | 180497 | 180497 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 23370646 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6843 | TotalRevenueColumn |
| Exclusion | $6,843 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 41188 | 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 | 41188 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 41188 | TotalRevenueColumn |
| Exclusion | $41,188 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 373198 | Securities |
| Other | 1500 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 6123 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 373198 | Securities |
| Other | -4623 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 368575 | TotalRevenueColumn |
| Exclusion | $368,575 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLANEOUS | 900099 | 198551 | $198,551 |
| MEAL INCOME | 900099 | 52740 | $52,740 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 251291 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24072080 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23370646 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $667,897 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 533222 | Total |
| Program Services | 533222 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3523 | Total |
| Program Services | 3523 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10698117 | Total |
| Program Services | 7852126 | ProgramServices |
| Management And General | 2845991 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 457866 | Total |
| Program Services | 320171 | ProgramServices |
| Management And General | 137695 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3024271 | Total |
| Program Services | 2109877 | ProgramServices |
| Management And General | 914394 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 664428 | Total |
| Program Services | 496002 | ProgramServices |
| Management And General | 168426 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46820 | Total |
| Management And General | 46820 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94386 | Total |
| Management And General | 94386 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1537438 | Total |
| Program Services | 1248398 | ProgramServices |
| Management And General | 289040 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4646 | Total |
| Program Services | 199 | ProgramServices |
| Management And General | 4447 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1199047 | Total |
| Program Services | 814090 | ProgramServices |
| Management And General | 384957 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 389705 | Total |
| Program Services | 57168 | ProgramServices |
| Management And General | 332537 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 539777 | Total |
| Program Services | 161550 | ProgramServices |
| Management And General | 378227 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94233 | Total |
| Program Services | 48658 | ProgramServices |
| Management And General | 45575 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 479 | Total |
| Program Services | 365 | ProgramServices |
| Management And General | 114 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151246 | Total |
| Program Services | 150564 | ProgramServices |
| Management And General | 682 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 757309 | Total |
| Program Services | 757309 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104141 | Total |
| Program Services | 65554 | ProgramServices |
| Management And General | 38587 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 2045041 | 1919286 | 125755 |
| BAD DEBTS | 699910 | 171289 | 528621 |
| MEDICAID SURCHARGE | 316948 | 316948 | |
| FOOD | 226875 | 37220 | 189655 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 573925 | Total |
| Program Services | 189626 | ProgramServices |
| Management And General | 384299 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24163353 | Total |
| Program Services | 16936197 | ProgramServices |
| Management And General | 7227156 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1683007 | BOY |
| EOY | 1788867 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3571565 | BOY |
| EOY | 3347382 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 337456 | BOY |
| EOY | 312449 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 151641 | BOY |
| EOY | 173785 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 15096699 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7628367 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6858345 | BOY |
| EOY | 7468332 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5910645 | BOY |
| EOY | 5554750 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 696196 | BOY |
| EOY | 632363 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 431843 | BOY |
| EOY | 117514 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19640698 | BOY |
| EOY | 19395442 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1848224 | BOY |
| EOY | 1916671 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18641 | BOY |
| EOY | 17021 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8508 | BOY |
| EOY | 6724 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2611293 | BOY |
| EOY | 2535244 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 591157 | BOY |
| EOY | 692852 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5077823 | BOY |
| EOY | 5168512 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14539511 | BOY |
| EOY | 14203003 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23364 | BOY |
| EOY | 23927 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14562875 | BOY |
| EOY | 14226930 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19640698 | BOY |
| EOY | 19395442 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -91273 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -244672 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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) |
|---|---|---|
| Number DA Fs Held | 1 | NumberDAFsHeld |
| Donor Advised Contributions | 757 | DonorAdvisedContributions |
| Grants Paid From Donor Funds | 250 | GrantsPaidFromDonorFunds |
| Aggregate DAF Value | 23928 | AggregateDAFValue |
| Disclosed Orgs Legal Control | 1 | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | 1 | DisclosedForCharitablePurposes |
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
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 | 8824116 | OtherCostOrOtherBasis |
| Depreciation | 3500573 | Depreciation |
| Book Value | 5323543 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 279639 | OtherCostOrOtherBasis |
| Depreciation | 121142 | Depreciation |
| Book Value | 158497 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5680517 | OtherCostOrOtherBasis |
| Depreciation | 4006652 | Depreciation |
| Book Value | 1673865 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7468332 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSETS INTERNALLY DESIGNATED FOR CAPITAL ACQUISITIONS | Description |
| Book Value | 5554750 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 5554750 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $160,000 |
| ASSET RETIREMENT OBLIGATION | $102,799 |
| DUE TO AFFILIATES | $430,053 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 692852 | TotalOfAmounts |
| Total Revenue | 24072080 | TotalRevenue |
| Total Expenses | 24163353 | TotalExpenses |
| Excess Or Deficit For Year | -91273 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -244672 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -244672 | TotalAdjustments |
| Excess Or Deficit Per FS | -335945 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 23663125 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -244672 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -244672 | RevenueNotRptdF990 |
| Revenue Subtotal | 23907797 | RevenueSubtotal |
| Other Revenues Not Included | 164283 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 164283 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 24072080 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 23630131 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 23630131 | ExpensesSubtotal |
| Other Expenses Not Included | 533222 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 533222 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 24163353 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 2B: | RESIDENT TRUST FUNDS ARE HELD BY THE ORGANIZATION ON BEHALF OF THE RESIDENTS IN A SEPARATE BANK ACCOUNT. | |
| PART X: | THE ORGANIZATION IS A NOT FOR PROFIT ORGANIZATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE YEARS 2008 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| GRANT INCOME - OPERATING 32,866. INVESTMENT INCOME 135,369. RESTRICTED CONTRIBUTIONS 563. LOSS ON SALE OF ASSETS -4,623. UNRESTRICTED CONTRIBUTIONS 108. | PART XII, LINE 4B - OTHER ADJUSTMENTS: | |
| CONTRIBUTION TO CENTRACARE FOUNDATION 50,000. TRANSFER TO CENTRACARE HEALTH SYSTEM 483,222. | PART XIII, 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 |
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 | 663320 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 663320 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02750 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3169708 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1954974 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1214734 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05030 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3833028 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1954974 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1878054 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07780 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10918 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10918 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1078253 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1078253 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04460 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 331 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 331 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1089502 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1089502 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04510 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4922530 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1954974 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2967556 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12290 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $699,910 | BadDebtExpenseAmount |
| Amount Attributable To | 179611 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5673345 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5577481 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 95864 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| 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 | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 SOUTHEAST NINTH STREET | 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 | SNF & PROVIDER BASED RURAL HEALTH CLINIC | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| 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 In Emergency Room | X | PostedInEmergencyRoom |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| 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 | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CCHS - LP NURSING HOME | ||||
| 20 SE NINTH STREET | LONG PRAIRIE | MN | 56347 | SKILLED NURSING FACILITY |
| CCHS - LONG PRAIRIE CLINIC | ||||
| 20 SE NINTH STREET | LONG PRAIRIE | MN | 56347 | PROVIDER BASED RURAL HEALTH CLINIC |
| CCHS - LP EAGLE VALLEY CLINIC | ||||
| 815 HIGHWAY 71 SOUTH | EAGLE BEND | MN | 56446 | PROVIDER BASED RURAL HEALTH CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE COSTING METHODOLOGY USED WAS DERIVED FROM THE COST TO CHARGE RATIO BASED ON WORKSHEET 2 OF THE IRS SCHEDULE H INSTRUCTIONS. | ||
| PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES INCLUDED ON LINE 7G INCLUDES CCHS-LP'S SKILLED NURSING FACILITY LOSS OF $1,078,253. THIS WAS CALULATED BY THE DIFFERENCE BETWEEN THE MEDICARE COST REPORT WORKSHEET D-1, PART 1 SNF CHARGES LESS COST. | ||
| PART I, L7 COL(F): IN THE CALCULATION OF THE AMOUNTS INCLUDED IN PART I, LINE 7, COLUMN F THERE WAS $699,910 OF BAD DEBT EXPENSE ELIMINATED. | ||
| PART III, LINE 4: THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:THE ORGANIZATION PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE SELF-PAY AND MISCELLANEOUS COMMERCIAL INSURANCE ACCOUNTS. PAYMENTS FOR SERVICES IS REQUIRED UPON RECEIPT OF AN INVOICE, AFTER PAYMENT BY INSURANCE, IF ANY. SELF-PAY ACCOUNTS ARE ANALYZED FOR COLLECTIBILITY BASED ON THE MONTHS PAST DUE AND PAYMENT HISTORY. AN ALLOWANCE IS ESTIMATED FOR THESE ACCOUNTS BASED ON THE HISTORICAL EXPERIENCE OF THE ORGANIZATION. THE AMOUNT AT BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNT CHARGES AND PER DIEM RATES. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. | ||
| PART III, LINE 8: THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED IN PART III, LINE 6 IS DERIVED FROM THE ORGANIZATION'S 2012 FILED MEDICARE COST REPORT.THERE WAS NO SHORTFALL CALCULATED IN PART III, LINE 7. THE SURPLUS IS REASONABLE GIVEN THE FACT THAT CENTRACARE HEALTH SYSTEM - LONG PRAIRIE IS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED BY MEDICARE AT COST PLUS 1%. | ||
| PART III, LINE 9B: THE ORGANIZATION'S COLLECTION POLICY REQUIRES THE COLLECTION STAFF TO OFFER CHARITY CARE TO PATIENTS WHO INDICATE THAT PAYMENT FOR SERVICES PROVIDED BY OUR FACILITY MIGHT BE AN ISSUE. IF A PATIENT QUALIFIES FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THIS POLICY APPLIES TO BOTH FACILITY BASED OR CONTRACTED AGENCY COLLECTION STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT RATING AGENCIES. | ||
| PART V, SECTION B, LINE 13G: A COPY OF THE PATIENT FINANCIAL SERVICES BROCHURE IS INCLUDED IN THE HOSPITAL INPATIENT PACKET OF INFORMATION WHICH IS PROVIDED IN EACH PATIENT ROOM. | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | |
| PART V, SECTION B, LINE 17E: OUR 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 SYSTEM - LONG PRAIRIE | |
| PART V, SECTION B, LINE 19D: PER THE AGREEMENT WITH THE STATE OF MINNESOTA ATTORNEY GENERAL, THE ORGANIZATION PROVIDES A DISCOUNT TO THE UNINSURED AND LOW-INCOME INSURED EQUAL TO THE AVERAGE DISCOUNT OF OUR LARGEST (BY VOLUME) NON-GOVERNMENTAL PAYOR. | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | |
| PART VI, LINE 2: THE ORGANIZATION'S STRATEGIC PLAN INCLUDES ASSESSING THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE GOVERNING BOARD THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, RECOMMENDATIONS FOR HEALTH CARE SERVICES. | ||
| PART VI, LINE 3: THE ORGANIZATION'S ADMISSIONS AND BILLING STAFF COMMUNICATE VERBALLY OR VIA LETTER REGARDING OUR CHARITY CARE AND VARIOUS FEDERAL, STATE, AND LOCAL ASSISTANCE PROGRAMS. | ||
| PART VI, LINE 4: THE COMMUNITY OF LONG PRAIRIE AND THE SURROUNDING AREA CONSISTS OF APPROXIMATELY 3,458 PEOPLE. THE 2010 DEMOGRAPHIC INFORMATION INDICATES A SENIOR POPULATION (60 YEARS OR OLDER) MAKES UP 17.4% OF THE TOTAL MARKET POPULATION. THE PER CAPITA INCOME OF THE RESIDENTS IN OUR AREA IS EXTREMELY DEPRESSED AT $21,390 COMPARED TO A STATE AVERAGE OF $29,431. TODD COUNTY IS RANKED 86TH, OR SECOND TO THE LAST, IN PER CAPITA INCOME IN THE STATE OF MINNESOTA. | ||
| PART VI, LINE 5: ONE OF THE LARGER COMMUNITY BUILDING ACTIVITIES THE ORGANIZATION IS INVOLVED IN IS A HOSTING A COMMUNITY HEALTH FAIR THAT OFFERS FREE SCREENINGS, EDUCATION BOOTHS AND HEALTH INFORMATION TO OUR AREA. MANY OTHER SPECIALTY CLINICS ARE INVOLVED TO OFFER EDUCATION ON THEIR TOPICS. OUR HOSPITAL ALSO PUTS ON MANY SMALL BUSINESS HEALTH FAIRS. WE GO INTO THE BUSINESS AND OFFER FREE SCREENINGS AND ASSESSMENTS TO THEIR EMPLOYEES. THE GOAL IS TO KEEP EMPLOYEES SAFE AND HEALTHY. ALSO, QUARTERLY FREE SCREENINGS ARE AVAILABLE THROUGH OUR FACILITY AT THE LOCAL GROCERY STORE. THE ORGANIZATION ALSO PROMOTES HEALTH CARE RELATED JOBS EDUCATION TO THE STUDENTS IN THE COMMUNITY. EACH SPRING AND FALL, IN CONJUNCTION WITH THE LOCAL HIGH SCHOOL, WE OFFERED A JUNIOR/SENIOR HEALTH CARE CAREERS CLASS WHICH INCLUDES JOB SHADOWING ON SITE. STAFF PARTICIPATES IN COMMUNITY ORGANIZATIONS TO PROVIDE HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATIONS EVENTS, INCLUDING THE LONG PRAIRIE CHAMBER OF COMMERCE, THE LONG PRAIRIE TRAILS COMMITTEE, PRAIRIEFEST, ETC. THE BE A LOSER WELLNESS CHALLENGE IS A COMMUNITY BASED PROJECT THAT THE ORGANIZATION PARTICIPATED IN TO SUPPORT HEALTHY LIFESTYLES. THE ORGANIZATION OFFERS REGULAR CPR CLASSES TO AREA SCHOOL STUDENTS AS WELL AS THE PUBLIC. THE CLASS OFFERS CPR TRAINING TO BECOME CERTIFIED IN CPR. THE ORGANIZATION PARTICIPATES WITH THE MULTI-SPECIALTY CLINIC AND HEALTH SYSTEM LEADERSHIP WITHIN OUR OVERALL ORGANIZATION IN PROVIDING ACCESS TO CARE, SUPPORT GROUPS, EDUCATIONAL ACTIVITIES, AND FINANCIAL CONTRIBUTIONS TO OUR AREA. THE ORGANIZATION RE-INVESTS ITS PROFITS BACK INTO EQUIPMENT AND SERVICES FOR THE HOSPITAL AND TO BENEFIT THE COMMUNITY IT SERVES. THIS ENSURES THE COMMUNITY CAN STAY CLOSE TO HOME FOR ITS SERVICES. THE ORGANIZATION OFFERS CHILD PREPARATION AND BREASTFEEDING CLASSES TO EXPECTING PARENTS IN THE AREA. THE CLASSES COVER THE LABOR AND BIRTH PROCESS, BREATHING AND RELAXATION TECHNIQUES, COMMON INTERVENTIONS, CAESAREAN BIRTHS, PAIN MEDICATION AND THE BENEFITS OF BREASTFEEDING. THESE CLASSES ARE ALSO AVAILABLE IN SPANISH TO ACCOMODATE OUR HISPANIC POPULATION. | ||
| 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 | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| CENTRACARE HEALTH FOUNDATION | |||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411855173 | 501(C)(3) | 50000 | TO SUPPORT GENERAL OPERATIONS |
| CENTRACARE HEALTH SYSTEM | |||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411813221 | 501(C)(3) | 483222 | TO SUPPORT GENERAL OPERATIONS |
| 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: CENTRACARE HEALTH SYSTEM IS A NOT-FOR-PROFIT CORPORATION 501(C)(3)THAT PROVIDES A COMPREHENSIVE PROGRAM OF HEALTH CARE SERVICES TO THE RESIDENTS OF CENTRAL MINNESOTA. AS PART OF THIS HEALTHFOCUSED MISSION, CENTRACARE HEALTH SYSTEM PROVIDES A LIMITED NUMBER OF CHARITABLE CONTRIBUTIONS TO ORGANIZATIONS THAT IMPROVE THE HEALTH OF CENTRAL MINNESOTANS. THE MAJORITY OF CONTRIBUTIONS ARE MADE IN THE FORM OF GRANTS THROUGH THE CENTRACARE HEALTH FOUNDATION. THE FOUNDATION'S GRANTS COMMITTEE REVIEWS FUNDING APPLICATIONS FROM PROGRAMS THROUGHOUT THE REGION. HOWEVER, THE CENTRACARE CONTRIBUTIONS COMMITTEE FUNCTIONS TO STREAMLINE HEALTH-RELATED CHARITABLE CONTRIBUTIONS THAT DO NOT FALL WITHIN THE FOUNDATION'S GUIDELINES. THIS POLICY OUTLINES THE PROCEDURES TO BE FOLLOWED AND THE CRITERIA TO BE CONSIDERED IN EVALUATING REQUESTS FOR FUNDING. CONTRIBUTIONS MUST BE IN KEEPING WITH THE MISSION OF CENTRACARE HEALTH SYSTEM, WHICH IS TO WORK TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. CONTRIBUTIONS WILL BE MADE TO ORGANIZATIONS RATHER THAN TO INDIVIDUALS WITHIN THE CENTRAL MINNESOTA REGION. CENTRACARE'S CHARITABLE FUNDS MAY NOT BE USED TO SUPPORT ANY ORGANIZATION OR EVENT THAT WOULD RESULT IN BENEFITS OF ANY KIND TO AN EMPLOYEE OF THE HEALTH SYSTEM OR A MEMBER OF THE VARIOUS BOARDS OF DIRECTORS, EITHER DIRECTLY OR INDIRECTLY. ONE EXCEPTION EXISTS TO THE GUIDELINE REGARDING BENEFIT TO EMPLOYEES: WE WILL SUPPORT, VIA SCHOLARSHIPS AND THE PURCHASE OF SUPPLIES, THE MEDICAL MISSION WORK OF OUR STAFF AND PHYSICIANS. THE CENTRACARE HEALTH SYSTEM CONTRIBUTIONS COMMITTEE IS MADE UP OF: ONE REPRESENTATIVE FROM CENTRACARE HEALTH FOUNDATION; ONE REPRESENTATIVE FROM ST. CLOUD HOSPITAL HUMAN RESOURCES; THE DIRECTOR OF CENTRACARE HEALTH SYSTEM'S COMMUNICATIONS DEPARTMENT AND THE COMMUNICATIONS/MARKETING SPECIALIST RESPONSIBLE FOR CENTRACARE CLINIC; THE DIRECTOR OF CENTRACARE HEALTH SYSTEM'S MARKETING/PLANNING DEPARTMENT; THE DIRECTOR OF ST. CLOUD HOSPITAL VOLUNTEER SERVICES; AND SI. CLOUD HOSPITAL'S DIRECTOR OF MISSION & SPIRITUAL CARE. THE COMMITTEE MEETS MONTHLY TO ENSURE A STREAMLINED, COORDINATED PROCESS OF REVIEWING REQUESTS AND DETERMINING FUNDING. THE COMMITTEE MAINTAINS A DATABASE TO TRACK ALL CONTRIBUTIONS. OTHER CENTRACARE ENTITIES, INCLUDING CENTRACARE HEALTH SYSTEM - LONG PRAIRIE, CENTRACARE HEALTH SYSTEM - MELROSE, AND ST BENEDICT'S SENIOR COMMUNITY MAY DEVELOP A BUDGET FOR APPROVAL AND IMPLEMENT THEIR OWN CONTRIBUTIONS DECISIONS WITHIN THE GUIDELINES OF THIS DOCUMENT. CONTRIBUTIONS MAY NOT EXCEED THE STATED BUDGET AND NO MULTI-YEAR COMMITMENTS TO ORGANIZATIONS MAY BE MADE WITHOUT APPROVAL FROM THE CENTRACARE HEALTH SYSTEM EXECUTIVE COUNCIL. INDIVIDUALS AND DEPARTMENTS FROM THROUGHOUT ST CLOUD HOSPITAL AND THE CENTRACARE CLINIC SITES IN ST. CLOUD SHOULD FORWARD ALL OUTSIDE FUNDING REQUESTS TO A MEMBER OF THE COMMITTEE FOR THE FULL GROUP'S CONSIDERATION. THOSE REQUESTING FUNDS SHOULD BE ASKED TO SUBMIT THEIR REQUEST IN WRITING. | Explanation |
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 (10 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES DAVIS | |||||||||||||
| 0 | 278990 | 0 | 52884 | 0 | 48714 | 0 | 15380 | 0 | 21302 | 0 | 417270 | 0 | 0 |
| ALLEN HORN MD | |||||||||||||
| 0 | 357539 | 0 | 94541 | 0 | 135736 | 0 | 86878 | 0 | 27205 | 0 | 701899 | 0 | 0 |
| GREGORY KLUGHERZ | |||||||||||||
| 0 | 368764 | 0 | 76230 | 0 | 79200 | 0 | 87297 | 0 | 19538 | 0 | 631029 | 0 | 0 |
| TERENCE PLADSON MD | |||||||||||||
| 0 | 745962 | 0 | 191627 | 0 | 10888 | 0 | 194986 | 0 | 18735 | 0 | 1162198 | 0 | 0 |
| PAUL HARRIS | |||||||||||||
| 0 | 250007 | 0 | 55565 | 0 | 2321 | 0 | 47172 | 0 | 36234 | 0 | 391299 | 0 | 0 |
| DANIEL SWENSON | |||||||||||||
| 0 | 164181 | 0 | 36256 | 0 | 16446 | 0 | 23492 | 0 | 25294 | 0 | 265669 | 0 | 0 |
| ERIC LOHN | |||||||||||||
| 0 | 165760 | 0 | 16892 | 0 | 6730 | 0 | 13895 | 0 | 8681 | 0 | 211958 | 0 | 0 |
| JAMES BERGMANN | |||||||||||||
| 151148 | 0 | 14880 | 0 | 1133 | 0 | 12549 | 0 | 14256 | 0 | 193966 | 0 | 0 | 0 |
| THOMAS HOCK | |||||||||||||
| 143193 | 0 | 2628 | 0 | 413 | 0 | 11051 | 0 | 24832 | 0 | 182117 | 0 | 0 | 0 |
| JOHN SECKINGER | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 283393 | 0 | 0 | 0 | 0 | 0 | 283393 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 4B | 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: - RECEIVED DISTRIBUTION OF 457(F): - GREGORY KLUGHERZ - $74,990 - DANIEL SWENSON - $14,817 - ALLEN HORN - $51,443 - JOHN SECKINGER - $283,393 - ACCRUED 457(F) EARNINGS: - GREGORY KLUGHERZ - $75,047 - TERENCE PLADSON - $176,611 - DANIEL SWENSON - $14,306 - PAUL HARRIS - $37,166 - ALLEN HORN - $53,154 | |
| 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 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. | |
| PART III | THE COMPENSATION PAID TO THE PRESIDENTS AND VICE-PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE THEIR COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. FORM 990 OF OTHER ORGANIZATIONS 4. WRITTEN EMPLOYEMENT CONTRACT 5. COMPENSATION SURVEY OR STUDY 6. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE | SUPPLEMENTAL INFORMATION |
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 THE CORPORATION. | |
| 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 CORPORATION'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 IRS 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 CONFLICTS OF INTEREST QUESTIONNAIRE ON A BI-ANNUAL BASIS. ALL STAFF SIGNS CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF, AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM- OR HERSELF 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 C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AND ARE ALSO REPORTED PUBLICLY IN THE FORM 990. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -244,672. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART VII, SECTION A | THE COMPENSATED OFFICERS AND BOARD MEMBERS OF CENTRACARE HEALTH SYSTEM - LONG PRAIRIE SERVE MULTIPLE RELATED ORGANIZATIONS. EACH INDIVIDUAL WORKS APPROXIMATELY 40 HOURS PER WEEK ACROSS THE RELATED ORGANIZATIONS. | AVERAGE WEEKLY HOURS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 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 AVENUE 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 & LONG-TERM CARE | MN | 501(C)(3) | 3 | 0 | CCHS | |
| CENTRAL MINNESOTA EMERGENCY PHYSICIANS | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411708142 | EMERGENCY PHYSICIAN PRACTICE | MN | 501(C)(3) | 3 | N/A | 0 | |
| CENTRACARE CLINIC | |||||||||||
| 1200 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411806657 | MULTI-SPECIALTY PHYSICIAN CLINIC | MN | 501(C)(3) | 3 | 0 | CCHS | |
| CENTRACARE HEALTH FOUNDATION | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411855173 | FUNDRAISING | MN | 501(C)(3) | 7 | N/A | 0 | |
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 AVENUE 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 NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| 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 |
| 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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