2012-10-30T16:11:12-05:00 2012-03-31 420714325 MCGLADREY LLP 227 W FIRST ST STE 700 DULUTH MN 558021919 990 2011-04-01 411724637 LONGVILLE LAKES CLINIC INC LONG 2185464366 180 JORDAN LANE LONGVILLE MN 56655 KYLE BAUER 2185464366 2012-10-19 1 JULIE BOYER P01278549 2187278253 2011 2016-02-24 21:20:13Z KYLE BAUER 180 JORDAN LANE LONGVILLE MN 56655 543024 0 X N/A X 1992 MN TO PROVIDE PRIMARY MEDICAL CARE TO RESIDENTS OF THE LONGVILLE AREA. 18 18 12 18 0 0 12442 21525 451493 521421 59 78 0 0 463994 543024 0 0 0 0 290549 287756 0 0 0 418361 486162 708910 773918 -244916 -230894 225243 278256 225243 197234 0 81022 TO PROVIDE PRIMARY MEDICAL CARE TO RESIDENTS OF THE LONGVILLE AREA. 0 0 680408 521421 PROVIDED FULL-TIME PRIMARY MEDICAL CARE TO RESIDENTS OF THE LONGVILLE AREA FIVE DAYS A WEEK. 680408 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 12 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 1 1 1 1 1 0 0 1 1 0 0 1 1 0 1 0 MN X KYLE BAUER 2185467000 320 EAST MAIN ST CROSBY MN 56441 EARL W BEDARD 1.00 X X 0 0 0 MYRON MIDTHUN 1.00 X X 0 0 0 NANCY MORITZ 1.00 X 0 0 0 THEODORA SKATTUM 1.00 X 0 0 0 ROGER TWIGG 1.00 X X 0 0 0 RUTH HANSEN 1.00 X 0 0 0 DANNO MAHONEY 1.00 X 0 0 0 MARY ZILLMER 1.00 X 0 0 0 MIKE VANHORN 1.00 X 0 0 0 BETTY PLATISHA 1.00 X 0 0 0 ANDREA BEDARD 1.00 X 0 0 0 HARRY GOTTSCH 1.00 X X 0 0 0 BRIAN DOBSON 1.00 X 0 0 0 JOLIENNE LUNDQUIST 1.00 X 0 0 0 AL EBNET 1.00 X 0 0 0 DAVE KAUPHUSMAN 1.00 X 0 0 0 FLOYD HALE 1.00 X 0 0 0 RICHARD SCHILLER 1.00 X 0 0 0 KYLE BAUER 40.00 X 0 147500 31269 THERESA SULLIVAN 40.00 X 0 118500 27393 0 266000 58662 0 0 1 0 CENTRAL LAKES MEDICAL CLINIC 318 MAIN STREET CROSBY MN 56441 PHYSICIAN SERVICES 181931 1 21525 21525 PATIENT REVENUE 621500 521421 521421 521421 78 78 543024 521421 0 78 262616 262616 10238 10238 -5700 -5700 20602 20602 7350 7350 292166 241310 50856 53361 53361 55503 48303 7200 6713 6713 15533 15533 7396 7396 PROVISION FOR DOUBTFUL 22329 22329 PUBLIC RELATIONS 13125 13125 MINNESOTA CARE TAX 6516 6516 MISCELLANEOUS 4565 4565 1605 1605 773918 680408 93510 0 37700 50421 71707 97814 7346 4862 4926 2131 308582 185554 103564 123028 225243 278256 22649 28090 202594 169144 225243 197234 X 81022 0 81022 225243 278256 X -230894 311916 X 0 1 1 X 0 X 24536 21605 25131 12442 21525 105239 382864 462333 470924 451493 521421 2289035 407400 483938 496055 463935 542946 2394274 0 0 0 2394274 384 223 83 59 78 827 384 223 83 59 78 827 407784 484161 496138 463994 543024 2395101 0.99970 0.99940 0.00030 0.00060 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 308582 185554 123028 123028 DUE TO CUYUNA RANGE HOSPITAL DISTRICT 169144 169144 543024 773918 -230894 311916 311916 81022 PART XI, LINE 8 - OTHER ADJUSTMENTS: FORGIVENESS OF DEBT BY CUYUNA RANGE HOSPITAL DISTRICT 311,916. 0 0 0 0 0 0 0 0 0 KYLE BAUER 0 147500 0 0 0 0 0 11657 0 19612 0 178769 0 0 FORM 990, PART VI, SECTION A, LINE 6 CUYUNA RANGE HEALTH CORPORATION IS THE SOLE MEMBER OF LONGVILLE LAKES CLINIC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS CONSISTS OF EIGHTEEN DIRECTORS WHO ARE DESIGNATED BY CUYUNA RANGE HEALTH CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WILL BE PROVIDED TO THE GOVERNING BODY BEFORE BEING FILED. FORM 990, PART VI, SECTION B, LINE 15B THE COMPENSATION FOR KEY EMPLOYEES IS REVIEWED BY THE COMPENSATION COMMITTEE, ALL COMPENSATION IS REVIEWED AGAINST HHRAM AND MMGMA AVERAGES FOR REASONABLENESS. LONGVILLE LAKES CLINIC DOES NOT COMPENSATE ANY TOP MANAGEMENT OFFICIALS. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE AT THE REQUEST OF THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: FORGIVENESS OF DEBT BY CUYUNA RANGE HOSPITAL DISTRICT 311,916. TOTAL TO FORM 990, PART XI, LINE 5: 311,916. CUYUNA REGIONAL MEDICAL CENTER 320 E MAIN STREET CROSBY MN 56441 410879376 HEALTH CARE MN 115 N/A 0 CUYUNA RANGE HEALTH CORP 320 EAST MAIN STREET CROSBY MN 56441 411696402 HEALTH CARE MN CUYUNA RANGE HOSPITAL DISTRICT C 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 1 0 1