2011-11-10T11:59:21-06:00 2010-12-31 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2010-01-01 363255877 Lakeland Hospice and Home Care Inc LAKE 2189981400 PO Box 824 Fergus Falls MN 56537 Ed Strand 2189981400 2011-11-09 1 LISA CHAFFEE CPA 7012398500 2011-11-09 2010 2016-03-07 17:11:31Z Patricia Skogen PO Box 824 Fergus Falls MN 56537 4695589 0 X www.lakelandhospice.org X 1984 MN Patient Support 12 12 122 72 0 0 1078796 592019 5105755 4103510 -33935 -1892 0 0 6150616 4693637 0 0 0 0 3325453 3106836 0 0 32806 2167330 1712540 5492783 4819376 657833 -125739 4084443 3711567 2708916 2461779 1375527 1249788 The purpose of Lakeland Hospice & Home Care is to provide compassionate, emotional, spiritual, and quality healthcare to each patient, promoting independence, comfort, and dignity in all stages of life's journey. 0 0 2566420 2869229 Hospice: To provide compassionate comfort care and support for patients of all types of illnesses and all ages. Services provided include home health aides, social workers, spiritual care, volunteers and grief support. Lakeland Hospice services cover 16 counties in the area. As part of the hospice program, an 8 bed hospice house is also operated. 1064617 1234281 Home Care assists individuals to remain in their own home setting with the focus of returning each individual to their best level of functioning through assessments and interventions of skilled nursing, physical, occupational and speech therapy, medical social worker and home health aids. 3631037 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 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 0 0 0 0 0 1 6 0 1 122 1 0 0 0 0 0 0 0 0 0 0 X 12 12 1 1 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 0 0 MN X Dawn Stavaas 2189981400 PO Box 824 Fergus Falls MN 56537 Rev Dr Roger Parks 0.50 X X 0 0 0 Nathan Johnson 0.50 X X 0 0 0 Rebecca Odden 0.50 X X 0 0 0 Diane Thorson 0.50 X X 0 0 0 Carol Juul 0.50 X X 0 0 0 Edward Strand 0.50 X X 0 0 0 Jim Worner 0.50 X 0 0 0 Larry Schulz 0.50 X 0 0 0 Marie Braaten 0.50 X 0 0 0 David Schneeberger 0.50 X 0 0 0 Rod Votava 0.50 X 0 0 0 Connie Seltz 0.50 X 0 0 0 John Richards 0.50 X 0 0 0 Angelo Greigo 0.50 X 0 0 0 Pat Krekelberg 0.50 X 0 0 0 Tom Peterson 0.50 X 0 0 0 Patricia Skogen 24.00 X 110000 0 0 110000 0 0 0 0 0 1 Pathway Health Services 2025 Fourth Street White Bear Lake MN 55110 Interim Administrator 148670 Lake Region Health Care 712 Cascade St S Fergus Falls MN 56537 Medical Services 101779 2 592019 592019 Net Patient Revenue 623000 4027829 4027829 Contracted Services 561000 74405 74405 Miscellaneous Revenue 900099 1276 1276 4103510 60 60 1952 -1952 -1952 -1952 4693637 4103510 0 -1892 110000 110000 2600001 1713592 886409 190488 125546 64942 206347 135998 70349 38670 38670 15076 15076 242134 242134 36962 8174 28788 504690 503613 1077 131829 131829 123630 122839 791 9701 2812 6889 106333 106333 239105 239105 21481 21481 Nursing Home Expense 225127 225127 17802 13784 4018 4819376 3631037 1155533 32806 20159 43603 673268 474480 19508 21648 22107 48327 3637650 514141 3349401 3123509 4084443 3711567 616322 624605 2043844 1837174 48750 2708916 2461779 X 1375527 1249788 1375527 1249788 4084443 3711567 -125739 0 X 0 1 1 X 0 X 390074 222990 465061 1078796 592019 2748940 390074 222990 465061 1078796 592019 2748940 2748940 57114 12660 3849 2203 60 75886 3052 10542 13594 2838420 20273085 0.96850 0.36570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 126828 126828 2714250 124502 2589748 796572 389639 406933 3123509 4693637 4819376 -125739 0 -125739 4693637 0 4693637 0 4693637 4819376 0 4819376 0 4819376 Description of Uncertain Tax Positions Under FIN 48: Part X: Lakeland is organized as a Minnesota nonprofit corporation and has been recognized by the Internal Revenue Service as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). Lakeland undergoes an annual analysis of its various tax positions, assessing the likelihood of these positions being upheld upon examination of relevant tax authorities, as defined by the accounting principles generally accepted in the United States of America. Lakeland believes that it is compliant with all IRS tax regulations and as of December 31, 2010, has not recorded a tax liability for a tax uncertainty. Lakeland will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. X X X X 0 0 0 0 0 0 0 0 0 Patricia Skogen 110000 0 0 0 0 0 0 0 0 0 110000 0 0 0 Supplemental Information Part III Patricia Skogen is compensated by Pathway Health Services, Inc. (an unrelated organization) for her Interim Administrator services to Lakeland Hospice and Home Care. Form 990, Part VI, Section A, line 2 Ed Strand, Larry Schultz, Angelo Griego and Jim Worner have a business relationship. Form 990, Part VI, Section A, line 3 Paid contracting company, Pathway Health Services, Inc., for interim administrator services. Form 990, Part VI, Section A, line 8b There are no committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11 The Accountant and treasurer reviewed the Form 990. After their review the board was provided the Form 990 electronically before being filed with the IRS. Form 990, Part VI, Section B, line 12c Board members are asked to disclose conflicts annually. If there is a conflict the board member is asked to abstain from voting. The Administrator and Board President review any conflicts disclosed. They make known to the full board any conflicts disclosed. Part VI, Line 15: In 2010, the Administrator was paid on a contracted basis through Pathway Health Services, Inc. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy and financial statements are available upon request.