LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC (EIN 41-0811697)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201102279349304490
- Schema version
- 2009v1.7
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T17:32:01-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LARSONALLEN 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 | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410811697 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEMORIAL HOSPITAL ASSOC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAKE | NameControl |
| Phone | 6514304581 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 927 WEST CHURCHILL STREET | AddressLine1 |
| City | STILLWATER | City |
| State | MN | State |
| ZIP Code | 55082 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Douglas E Johnson | Name |
| Title | CFO | Title |
| Phone | 6514304581 | Phone |
| Date Signed | 2011-08-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JEFFREY ROBERTSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 927 WEST CHURCHILL STREET | AddressLine1 |
| City | STILLWATER | City |
| State | MN | State |
| ZIP Code | 55082 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 98680484 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.LAKEVIEW.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1880 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 878 | TotalNbrEmployees |
| Total Nbr Volunteers | 325 | TotalNbrVolunteers |
| Total Gross UBI | 9418320 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -627275 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2857998 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5513348 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 90309347 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 87915159 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -88251 | InvestmentIncomePriorYear |
| Investment Income Current Year | -1813 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4806822 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5095879 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 97885916 | TotalRevenuePriorYear |
| Total Revenue Current Year | 98522573 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 6514530 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 12742277 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 43361618 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 41145649 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 45019052 | OtherExpensePriorYear |
| Other Expenses Current Year | 44913680 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 94895200 | TotalExpensesPriorYear |
| Total Expenses Current Year | 98801606 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2990716 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -279033 | RevenuesLessExpensesCY |
| Total Assets BOY | 58262604 | TotalAssetsBOY |
| Total Assets EOY | 61623717 | TotalAssetsEOY |
| Total Liabilities BOY | 22999104 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 23389068 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 35263500 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 38234649 | NetAssetsOrFundBalancesEOY |
| Mission Description | To deliver superior quality service in cooperation with others to meet the diverse healthcare needs of individuals, families and communities of the St. Croix Valley. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 82171703 | Expense |
| Grants | 12742277 | Grants |
| Revenue | 82759168 | Revenue |
| Description | Provided routine and emergency healthcare services to the community and surrounding area, and provided for the physical, emotional and spiritual needs of its patients. Approximately $477,000 was forgiven on expenses by the hospital for charity care services. | Description |
| Total Program Service Expense | 82171703 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| 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 |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 96 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 878 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Doug Johnson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6514304581 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 927 CHURCHILL STREET WEST | AddressLine1 |
| City | STILLWATER | City |
| State | MN | State |
| ZIP Code | 55082 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 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 | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| peter Clements | ||||||||
| chair | 2.00 | X | X | 0 | 0 | 0 | ||
| arba-Della Beck | ||||||||
| secretary | 2.00 | X | X | 0 | 0 | 0 | ||
| Bruce Bartie DO | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Kevin Bjork MD | ||||||||
| Board Member | 1.00 | X | 0 | 331432 | 17548 | |||
| Rebecca Billingsley | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Phil Donaldson | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| ron Phillippo | ||||||||
| board Member | 1.00 | X | 0 | 0 | 0 | |||
| david Reamer | ||||||||
| board Member | 1.00 | X | 0 | 0 | 0 | |||
| Jim Schug | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Jeffrey J Robertson | ||||||||
| CEO | 60.00 | X | X | 0 | 597790 | 75893 | ||
| Douglas E Johnson | ||||||||
| CFO & TREASURER | 60.00 | X | 0 | 316905 | 50047 | |||
| Curt Geissler | ||||||||
| PRESIDENT | 60.00 | X | 355297 | 0 | 65735 | |||
| Mary E Jones | ||||||||
| RN | 46.00 | 154839 | 0 | 0 | X | |||
| Jeffrey Maanum | ||||||||
| Lead Ultrasound Tech. | 55.00 | 147239 | 0 | 0 | X | |||
| Cynthia Appleseth | ||||||||
| Manager, Pharmacy | 40.00 | 145294 | 0 | 0 | X | |||
| Marcia McGowan | ||||||||
| PHARMACIST | 40.00 | 129560 | 0 | 0 | X | |||
| Jo Sittlow | ||||||||
| Senior Director | 40.00 | 145337 | 0 | 0 | X | |||
| James Albers | ||||||||
| Pharmacist | 40.00 | 126929 | 0 | 0 | X | |||
| Janice Arkell | ||||||||
| RN - Hospice | 40.00 | 127645 | 0 | 0 | X | |||
| Bonnie Eastvold | ||||||||
| RN | 40.00 | 106889 | 0 | 0 | X | |||
| Stephen Tatroe | ||||||||
| Pharmacist | 40.00 | 112967 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1551996 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1246127 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 209223 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| Welsch Construction LLC | |||||
| 4350 Baker Road Suite 400 | Minneapolis | MN | 55343 | Building Addition | 1630889 |
| BWBR Architects | |||||
| 380 St Peter Street Suite 600 | St Paul | MN | 55102 | Architectual Services | 979415 |
| Quest Diagnostics | |||||
| PO Box 12989 | Chicago | IL | 60693 | Reference Laboratory Service | 603163 |
| ST PAUL HEART CLINIC | |||||
| 225 SMITH AVE N | ST PAUL | MN | 55102 | Technician Services | 534250 |
| Nurse Anesthesia Services PA | |||||
| 8990 Springbrook Dr NW | Coon Rapids | MN | 55433 | Professional Nurse Anesthesia Call Pay S | 399996 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 21 | NumberOfContractorsGT100K |
| Related Organizations | 5468471 | RelatedOrganizations |
| All Other Contributions | 44877 | AllOtherContributions |
| Total Contributions | 5513348 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | net patient service | Description |
| Business Code | 621500 | BusinessCode |
| Total Revenue Column | 87915159 | TotalRevenueColumn |
| Related Or Exempt Function Income | 82759168 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 5155991 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 87915159 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7251 | TotalRevenueColumn |
| Exclusion | $7,251 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 75020 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 75020 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 75020 | TotalRevenueColumn |
| Exclusion | $75,020 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 148847 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 157911 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -9064 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9064 | TotalRevenueColumn |
| Exclusion | -$9,064 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| retail pharmacy | 446110 | 4224053 | 4224053 | |
| Joint Venture | 900099 | 756032 | $756,032 | |
| OTHER INCOME | 900099 | 40774 | 38276 | $2,498 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5020859 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 98522573 | TotalRevenueColumn |
| Related Or Exempt Function Income | 82759168 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 9418320 | UnrelatedBusinessRevenue |
| Exclusion | $831,737 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12742277 | Total |
| Program Services | 12742277 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 328212 | Total |
| Management And General | 328212 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31402245 | Total |
| Program Services | 26180452 | ProgramServices |
| Management And General | 5221793 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2784416 | Total |
| Management And General | 2784416 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4325587 | Total |
| Program Services | 1274731 | ProgramServices |
| Management And General | 3050856 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2305189 | Total |
| Program Services | 1986721 | ProgramServices |
| Management And General | 318468 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96892 | Total |
| Management And General | 96892 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124780 | Total |
| Management And General | 124780 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6850999 | Total |
| Program Services | 5475334 | ProgramServices |
| Management And General | 1375665 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 314620 | Total |
| Program Services | 3905 | ProgramServices |
| Management And General | 310715 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25881855 | Total |
| Program Services | 24991727 | ProgramServices |
| Management And General | 890128 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5863 | Total |
| Management And General | 5863 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 639945 | Total |
| Program Services | 7210 | ProgramServices |
| Management And General | 632735 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 345103 | Total |
| Program Services | 296864 | ProgramServices |
| Management And General | 48239 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3529080 | Total |
| Program Services | 3529080 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2392 | Total |
| Program Services | 2392 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| EQUIPMENT MAINTENANCE | 2678774 | 1945039 | 733735 |
| OVERHEAD ALLOCATION | 1874094 | 1874094 | |
| BAD DEBT | 1750575 | 1750575 | |
| COMMUNITY SERVICE | 459082 | 459082 | |
| OTHER EXPENSE | 359626 | 111302 | 248324 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98801606 | Total |
| Program Services | 82171703 | ProgramServices |
| Management And General | 16629903 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18561483 | BOY |
| EOY | 18151283 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 231496 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9737424 | BOY |
| EOY | 8423134 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1885478 | BOY |
| EOY | 1793533 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 801140 | BOY |
| EOY | 837263 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 73626056 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 42976974 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25463744 | BOY |
| EOY | 30649082 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1066890 | BOY |
| EOY | 1111562 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 514949 | BOY |
| EOY | 657860 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58262604 | BOY |
| EOY | 61623717 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6276006 | BOY |
| EOY | 7635632 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16723098 | BOY |
| EOY | 15753436 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22999104 | BOY |
| EOY | 23389068 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34765524 | BOY |
| EOY | 37774859 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 497976 | BOY |
| EOY | 459790 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35263500 | BOY |
| EOY | 38234649 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58262604 | BOY |
| EOY | 61623717 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $1,428 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1428 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | LAKEVIEW HOSPITAL ASSOCIATION, INC. PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND MINNESOTA HOSPITAL ASSOCIATION. THESE ASSOCIATIONS PARTCIPATE IN LOBBYING ACTIVITIES RELATED TO HEALTHCARE. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2532354 | OtherCostOrOtherBasis |
| Book Value | 2532354 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43369164 | OtherCostOrOtherBasis |
| Depreciation | 21810958 | Depreciation |
| Book Value | 21558206 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 272744 | OtherCostOrOtherBasis |
| Depreciation | 247184 | Depreciation |
| Book Value | 25560 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25696633 | OtherCostOrOtherBasis |
| Depreciation | 20918832 | Depreciation |
| Book Value | 4777801 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1755161 | OtherCostOrOtherBasis |
| Book Value | 1755161 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 30649082 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | pension reserve | Description |
| Amount | $15,753,436 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 15753436 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| 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 | 382437 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 382437 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00400 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8438040 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5392533 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3045507 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03160 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8820477 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5392533 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3427944 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03560 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 117073 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 117073 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26488 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 26488 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6493650 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3125568 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3368082 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03490 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 131921 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 131921 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6769132 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3125568 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3643564 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03780 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15589609 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8518101 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7071508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07340 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 13575 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 13575 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 13575 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 13575 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,615,781 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 18107767 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 19346776 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1239009 | 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 |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | High Pointe Surgery Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | Ambulatory Surgery Center | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.36200 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.63800 | PhysicansProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEMORIAL HOSPITAL ASSOC INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 927 CHURCHILL ST W | AddressLine1 |
| City | STILLWATER | City |
| State | MN | State |
| ZIP Code | 55082 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Annual Community Benefit Expln | Part I, Line 6a: The Lakeview Memorial Hospital Community benefit report is included in a report prepared by the Minnesota Hospital Association. | AnnualCommunityBenefitExpln |
| Costing Method Used | Part I, Line 7: IN COLUMN F, WHEN CALCULATING CHARITY-CARE AND MEANS-TESTED GOVERNMENT PROGRAMS AS A PERCENTAGE OF TOTAL EXPENSES, THE HOSPITAL ELIMINATED $1,750,575 OF BAD DEBT EXPENSE. | CostingMethodUsed |
| Bad Debt Footnote | Part III, Line 4: FROM NOTE 1 TO THE FINANCIAL STATEMENTS: "THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE SELF-PAY AND MISCELLANEOUS COMMERCIAL INSURANCE ACCOUNTS. PATIENTS ARE NOT REQUIRED TO PROVIDE COLLATERAL FOR SERVICES RENDERED. PAYMENT 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 HOSPITAL. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THE TIME."Bad debt expense represents those accounts receivable written off from patients that have the ability to pay, as determined from charity care applications and other documentation, but choose not to. The bad debt amount is the receivable after insurance payment and adjustments have already been made, including any adjustments for self pay in accordance with the agreement with the Minnesota Attorney General's office. For the purposes of community benefit calculations, the bad debt at cost is estimated by reducing the amount written off by our overall operating income rate for the year (reductions have already been made for discounts and other allowances, so it is inappropriate to estimate using the cost to charge ratio estimated for other "at cost" calculations in these worksheets). | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: The Medicare short-fall should be treated as community benefit because: 1) It provides services to a significant portion of our service population at a negative margin; 2) the hospital would discontinue providing services to Medicare patients if the decision were based strictly on a financial basis; 3) there is a community need to provide these services locally; 4) if the hospital did not provide these services, they would become the obligation of the government. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: IF A PATIENT WAS NOT IDENTIFIED AS A POTENTIAL CHARITY CARE CANDIDATE UPON REGISTRATION, THE FIRST COLLECTIONS CONTACT IS WITH THE HOSPITAL'S INTERNAL BUSINESS STAFF, WHO INTERVIEW THE PATIENT AND DETERMINE IF THE PATIENT IS A CANDIDATE FOR CHARITY CARE. IF THE PAPERWORK IS COMPLETED AND THEY DO QUALIFY FOR CHARITY CARE, THERE IS NO FURTHER COLLECTION ACTIVITY. HOWEVER, IF THE PAPERWORK IS NOT COMPLETED, OR IS COMPLETED AND THEY DO NOT MEET THE CRITERIA, THEY ARE SUBJECT TO FURTHER COLLECTION ACTIVITY. THIS FIRST OCCURS INTERNALLY THROUGH HOSPITAL STAFF. IF INTERNAL ATTEMPTS ARE UNSUCCESSFUL, THIS SUBSEQUENTLY OCCURS THROUGH OUTSIDE COLLECTION AGENCIES. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: Lakeview is an active participant in community and county government task forces on health needs assessment and health services planning and coordination. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: For Lakeview Hospital patients: Each patient billing statement and collections letter produced by Lakeview includes the following notice: Financial Assistance and Payment Arrangements: Lakeview Hospital offers financial assistance to patients experiencing difficulty paying their medical bills. If you are insured and are experiencing difficulty paying the balance of your medical bill, please contact our business office for more information about setting up a payment plan or about our charity care program. If you are uninsured and your annual household income is less than $125,000, please contact our business office for information on our uninsured discount program, setting up a payment plan, or our charity care program. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Our core and primary markets include central Washington County, Minnesota, including the immediate area of Stillwater, and also the nearby cities of Lake Elmo, Marine on the St. Croix, Bayport, Lakeland, and Afton in Minnesota, and Somerset, Houlton, Hudson, New Richmond and Star Prairie, Wisconsin. As our secondary service area, we serve nearby cities in eastern Minnesota and western Wisconsin. In Washington County, 15.8% of the population is over the age of 55. The over 65 age group grew by 61% between the 1990 and 2000 census, and is currently growing at 18% per year, the fastest increase in the 11 county Twin Cities area. It is estimated that the 65 and older group in Washington County will grow by 350% by 2030. Of the overall population of Washington County, 7.4% are individuals of color. The median income in Washington County was $74,000 in 2006, and the median income of individuals 65 and older was under $34,000 per year. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: As a member of Stillwater Health System, Lakeview Hospital 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 the market area described above. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: The organization's multi-specialty clinic participates in Minnesota community measurement; the clinic practices and measures provider performance with specific preventive care metrics and specific chronic disease management metrics. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: | AffiliatedHealthCareSystem |
| Reports Filed With States | MN | ReportsFiledWithStates |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| Human Services Inc | ||||||||||
| 7066 Stillwater Blvd N | OAKDALE | MN | 55128 | 410955577 | 501(C)(3) | 5000 | COMMUNITY BENEFIT | |||
| Stillwater Area Schools | ||||||||||
| 1875 Greeley St | STILLWATER | MN | 55082 | 416008519 | 501(C)(3) | 5000 | COMMUNITY BENEFIT | |||
| Youth Services Bureau | ||||||||||
| 101 W Pine St | STILLWATER | MN | 55082 | 411333578 | 501(C)(3) | 5000 | COMMUNITY BENEFIT | |||
| Young Life St Croix Valley | ||||||||||
| 1151 Parkwood Ln | STILLWATER | MN | 55082 | 840385934 | 501(C)(3) | 5000 | COMMUNITY BENEFIT | |||
| Community Thread | ||||||||||
| 2300 W Orleans St | STILLWATER | MN | 55082 | 410967271 | 501(C)(3) | 5000 | COMMUNITY BENEFIT | |||
| St Croix Chaplaincy Assn | ||||||||||
| PO Box 322 | STILLWATER | MN | 55082 | 411628281 | 501(C)(3) | 5000 | COMMUNITY BENEFIT | |||
| Family Means | ||||||||||
| 1875 Northwestern Ave | STILLWATER | MN | 55082 | 416045574 | 501(C)(3) | 6000 | COMMUNITY BENEFIT | |||
| STILLWATER HEALTH SYSTEM | ||||||||||
| 927 CHURCHILL STREET WEST | STILLWATER | MN | 55082 | 300221189 | 501(C)(3) | 4391603 | GENERAL OPERATIONS. | |||
| LAKEVIEW MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 927 CHURCHILL STREET WEST | STILLWATER | MN | 55082 | 411386635 | 501(C)(3) | 740118 | GENERAL OPERATIONS. | |||
| STILLWATER MEDICAL GROUP | ||||||||||
| 1500 Curve Crest Blvd | STILLWATER | MN | 55082 | 830379473 | 501(C)(3) | 7546978 | GENERAL OPERATIONS. | |||
| St Croix Family Medical | ||||||||||
| 5640 Memorial Avenue North | StiLLWATER | MN | 55082 | 237113299 | 501(C)(3) | COMMUNITY BENEFIT | 9688 | FMV | Lab Services | |
| STILLWATER MARATHON | ||||||||||
| PO Box 311 | StiLLWATER | MN | 55082 | 411787893 | 5000 | COMMUNTY BENEFIT | ||||
| THE PARTNERSHIP PLAN | ||||||||||
| PO BOX 582 | STILLWATER | MN | 55082 | 203012418 | 5250 | COMMUNTY BENEFIT | ||||
| HOPE ADOPTION AND FAMILY SERVICES INTERNATIONAL | ||||||||||
| 5850 OMAHA AVE N | OAK PARK HEIGHTS | MN | 55082 | 411296959 | 5000 | COMMUNITY BENEFIT | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 14 | 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: Grant applicants identify the intended purpose of funds during the application process. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kevin Bjork MD | |||||||||||||
| 0 | 303000 | 0 | 28432 | 0 | 0 | 0 | 0 | 0 | 17548 | 0 | 348980 | 0 | 0 |
| Jeffrey J Robertson | |||||||||||||
| 0 | 321343 | 0 | 75100 | 0 | 201347 | 0 | 25097 | 0 | 50796 | 0 | 673683 | 0 | 0 |
| Douglas E Johnson | |||||||||||||
| 0 | 199775 | 0 | 51047 | 0 | 66083 | 0 | 15206 | 0 | 34841 | 0 | 366952 | 0 | 0 |
| Curt Geissler | |||||||||||||
| 226016 | 0 | 46376 | 0 | 82905 | 0 | 19178 | 0 | 46557 | 0 | 421032 | 0 | 0 | 0 |
| Mary E Jones | |||||||||||||
| 154839 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 154839 | 0 | 0 | 0 |
| James Albers | |||||||||||||
| 126929 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 126929 | 0 | 0 | 0 |
| Janice Arkell | |||||||||||||
| 127645 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 127645 | 0 | 0 | 0 |
| Bonnie Eastvold | |||||||||||||
| 106889 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 106889 | 0 | 0 | 0 |
| Stephen Tatroe | |||||||||||||
| 112967 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 112967 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | JEFF ROBERTSON, CEO, AND DOUG JOHNSON, CFO, ARE PAID BY STILLWATER HEALTH SYSTEM, A MINNESOTA NOT-FOR-PROFIT ORGANIZATION AND RELATED ORGANIZATION. STILLWATER HEALTH SYSTEM USES THE FOLLOWING METHODS TO ESTABLISH THEIR COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEY 4. APPROVAL BY THE BOARD OF DIRECTORS AND COMPENSATION COMMITTEE | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | THE SOLE MEMBER IS STILLWATER HEALTH SYSTEM. | |
| Form 990, Part VI, Section A, line 7a | THE PRESIDENT OF STILLWATER HEALTH SYSTEM IS APPOINTED BY THE MEMBER AND IS AUTOMATICALLY GIVEN A POSITION AS A VOTING MEMBER OF THE BOARD OF DIRECTORS OF LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION. | |
| Form 990, Part VI, Section A, line 7b | THE MEMBER HAS RESERVED TO ITSELF THE FOLLOWING POWERS CONCERNING THE GOVERNANCE OF LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION: A. RATIFICATION, APPROVAL AND REMOVAL OF ALL MEMBERS OF THE BOARD OF DIRECTORS WITH OR WITHOUT CAUSE. B. APPROVAL OF ANY MISSION OR VISION STATEMENT OR STATEMENT OF CORPORATE PURPOSE. C. APPROVAL OF THE STRATEGIC PLANS, CAPITAL BUDGETS, OPERATING BUDGETS AND FINANCIAL POLICIES. D. APPROVAL OF ANY PLANS OF MERGER OR CONSOLIDATION WITH ANY FOREIGN OR DOMESTIC CORPORATION, VOLUNTARY DISSOLUTION, OR SALE, LEASE OR TRANSFER OF THE HOSPITAL'S REAL ESTATE OR A SIGNIFICANT PORTION OF ITS OPERATIONS OR ASSETS. E. APPROVAL OF THE GRANT OF A SECURITY INTEREST IN ALL OR SUBSTANTIALLY ALL OF THE HOSPITAL'S ASSETS, OR THE INCURRENCE OF INDEBTEDNESS OR THE GUARANTEE OF ANY INDEBTEDNESS. F. APPROVAL OF INDIVIDUAL CAPITAL EXPENDITURES IN EXCESS OF $500,000. G. APPROVAL OF PHYSICIAN, EMPLOYEE AND EXECUTIVE COMPENSATION PLANS, INCLUDING CRITERIA FOR INCENTIVE COMPENSATION ARRANGEMENTS. H. APPROVAL OF ALL SUBSTANTIVE AFFILIATIONS BETWEEN THE HOSPITAL AND A THIRD PARTY. I. APPROVAL OF CONFLICTS OF INTEREST POLICIES. | |
| Form 990, Part VI, Section B, line 11 | THE HOSPITAL'S DRAFT 990 WAS REVIEWED AND APPROVED BY THE CFO, THEN DISTRIBUTED ELECTRONICALLY TO ALL LAKEVIEW HOSPITAL AND STILLWATER HEALTH SYSTEM BOARD MEMBERS (VOTING AND NON-VOTING). THE FORM 990 WAS REVIEWED BY THE STILLWATER HEALTH SYSTEM AUDIT COMMITTEE. A COPY OF THE FINAL FORM 990 WAS SENT ELECTRONICALLY TO ALL BOARD MEMBERS PRIOR TO FILING. | |
| Form 990, Part VI, Section B, line 12c | THE ORGANIZATION REQUIRES INTERESTED PERSONS TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. INTERESTED PERSONS ARE EXCLUDED FROM DELIBERATIONS AND VOTES PERTAINING TO THE TRANSACTION OR ARRANGEMENT. ALTERNATIVES TO THE TRANSACTION OR ARRANGEMENT ARE EXPLORED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE IDENTIFIED THAT DOES NOT GIVE RISE TO CONFLICT OF INTEREST, THE BOARD CONSIDERS THE TRANSACTION OR ARRANGEMENT BASED ON ITS BENEFIT TO THE CORPORATION. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE POSSIBLE CONFLICTS OF INTEREST, IT INFORMS THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORDS THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS IS WARRANTED, THE BOARD DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT TAKES APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. THE BOARD OF DIRECTORS AND OFFICERS ARE COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. DETERMINATIONS OF CONFLICTS OF INTEREST ARE MADE AND REVIEWED AT THE CLINIC PROVIDER LEVEL AND AT THE CORPORATION EXECUTIVE AND BOARD LEVEL. | |
| THE DETERMINATION OF THE COMPENSATION OF LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION'S OFFICERS AND BOARD MEMBERS IS CONDUCTED BY A RELATED ORGANIZATION. IN 2010, LAKEVIEW HEALTH SYSTEM'S COMPENSATION COMMITTEE RETAINED AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTING FIRM TO PROVIDE A COMPREHENSIVE MARKET COMPARISON FOR THE FOLLOWING EXECUTIVE POSITIONS WITHIN LAKEVIEW HEALTH: SYSTEM CEO, SYSTEM CFO, CLINIC PRESIDENT, CLINIC ADMINISTRATOR AND HOSPITAL PRESIDENT. THE DATA FROM THE 2009 ANALYSIS ALLOWED THE COMMITTEE TO LEARN THE COMPENSATION RATES THAT ARE CONSIDERED P50 TO P60 OF MARKET FOR COMPARABLE LAKEVIEW POSITIONS. OTHER CONSIDERATIONS BY THE COMMITTEE INCLUDE: ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES, INDIVIDUAL PERFORMANCE, EXPERIENCE, SUBJECTIVE EVALUATION BY BOARD MEMBERS, GENERAL ECONOMIC CONDITIONS, COSTS OF REPLACEMENT, PREVAILING COMMUNITY ATTITUDES AND BELIEFS REGARDING EXECUTIVE COMPENSATION. THE PROCESS OF DETERMINING THE OFFICERS AND BOARD MEMBERS' COMPENSATION INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2010. | ||
| Form 990, Part VI, Section C, line 19 | THE HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE HOSPITAL'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH ITS ANNUAL REPORT. | |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS, THE CEO, AND THE CFO. THE CEO AND CFO ARE NOT VOTING MEMBERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OR DIRECTORS. | |
| FORM 990, PART VII, SECTION A | THE COMPENSATED BOARD MEMBERS AND OFFICERS FREQUENTLY DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS IN A PARTICULAR WEEK. EACH INDIVIDUAL WORKS AN AVERAGE OF APPROXIMATELY 60 HOURS PER WEEK FOR LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION AND ITS RELATED ORGANIZATIONS. | AVERAGE WEEKLY HOURS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 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 |
|---|---|---|---|---|---|---|---|---|---|
| Stillwater Health System | |||||||||
| 927 Churchill St W | STILLATER | MN | 55082 | 300221189 | HEALTH CARE | MN | 501(C)(3) | 11 - TYPE 2 | N/A |
| Lakeview Memorial Hospital Foundation | |||||||||
| 927 Churchill St W | STILLATER | MN | 55082 | 411386635 | foundation | MN | 501(C)(3) | 11 - TYPE 2 | N/A |
| ST CROIX VALLEY HEALTH AND CARE RESEARCH FOUNDATION | |||||||||
| 1500 Churchill BLVD | STILLATER | MN | 55082 | 411923524 | foundation | MN | 501(C)(3) | PF | N/A |
| STILLWATER MEDICAL GROUP | |||||||||
| 1500 Churchill BLVD | STILLATER | MN | 55082 | 830379473 | HOSPITAL | MN | 501(C)(3) | 9 | N/A |
| 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 | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 1 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
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