2026-07-28T11:19:39-05:00 2025-12-31 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2025-01-01 411949230 GLENCOE REGIONAL HEALTH SERVICES GLEN 3208643121 1805 HENNEPIN AVENUE NORTH GLENCOE MN 553361416 ANGELA ERICKSON CFO 3208643121 2026-07-27 1 JUSTIN HARTERT P02236744 5074467100 2026-07-27 2025 2025-03-06 01:10:19Z GLENCOE REGIONAL HEALTH ANGELA ERICKSON 1805 HENNEPIN AVENUE NORTH GLENCOE MN 553361416 109535038 0 X WWW.GLENCOEHEALTH.ORG X 1999 MN TO IMPROVE EVERY LIFE BY OFFERING HIGH-QUALITY, SAFE, AND ACCESSIBLE HEALTHCARE. 7 4 824 70 0 0 1311869 511355 87237783 96206602 4975978 3382716 447564 573581 93973194 100674254 52620 92876 0 0 57751487 62100903 0 0 0 30180147 33655018 87984254 95848797 5988940 4825457 130963775 139837947 29406804 30517669 101556971 109320278 X GLENCOE REGIONAL HEALTH SERVICES EXISTS TO IMPROVE EVERY LIFE BY OFFERING HIGH-QUALITY, SAFE, AND ACCESSIBLE HEALTHCARE. WE ARE DEDICATED TO STRENGTHENING HEALTHCARE BY CONNECTING OUR COMMUNITIES, ENHANCING THE PATIENT EXPERIENCE, ELEVATING EMPLOYEE ENGAGEMENT, AND DELIVERING ON CLINICAL EXCELLENCE. 0 0 53634608 92876 81371954 HOSPITAL - THE FACILITY IS LICENSED FOR 49 BEDS. MEDICAL/SURGICAL SERVICES ARE PROVIDED FOR ACUTE AND SWING BED PATIENTS. MAJOR SERVICES PROVIDED INCLUDE ER, MEDICAL IMAGING, SURGERY, LABORATORY, REHABILITATION THERAPY, ADVANCED WOUND CARE, AND CLINIC SERVICES. AS PART OF REGULAR OPERATIONS, PATIENT CARE IS PRIORITIZED THROUGH OUR VALUES OF COMPASSION, AUTHENTICITY, RESPECT, EXCELLENCE, AND SAFETY. THREE ADVANCED PRACTICE PROVIDER POSITIONS WERE ADDED IN LATE 2024 AND AVAILABLE TO SEE PATIENTS AT THE START OF 2025; THESE ADDITIONS ENHANCED ACCESS TO FAMILY MEDICINE AND UROLOGY AND DECREASED WAIT TIMES FOR PATIENTS. IN ADDITION, WE EMPLOY TWO SPANISH-SPEAKING INTERPRETERS TO SUPPORT PATIENTS IN SEVERAL AREAS, INCLUDING CLINIC, EMERGENCY, BIRTH SERVICES, AND APPOINTMENT SCHEDULING. 9368644 0 14213674 NURSING HOME - THE LONG-TERM CARE UNIT IS A 108-BED SKILLED NURSING FACILITY, WITH ALL BEDS MEDICARE AND MEDICAID-CERTIFIED. WHILE HERE, RESIDENTS ENJOY A PERSON-CENTERED APPROACH TO CARE THAT INCLUDES PRIVATE SPACES ALONG WITH HOME-LIKE AMENITIES AND FLEXIBLE ROUTINES. THIS MODEL IS PROVEN TO PROVIDE RESIDENTS GREATER AUTONOMY AND CLOSER RELATIONSHIPS WITH CROSS-TRAINED STAFF. IN ADDITION, WEEKLY ACTIVITIES ARE AVAILABLE TO MEET A VARIETY OF RESIDENT INTERESTS. FOR EXAMPLE, WE HOSTED THE FIRST ANNUAL PATCHWORK PALOOZA, A DISPLAY OF HANDMADE QUILTS FROM COMMUNITY MEMBERS. FINALLY, COMMUNITY VOLUNTEERS ENGAGE WITH RESIDENTS IN A VARIETY OF WAYS TO HELP COMBAT SOCIAL ISOLATION, INCLUDING TRIPS ON OUR TRISHAW BIKE, GARDENING, AND TRANSPORT SUPPORT DURING THE ORGANIZATION'S RUN/WALK EVENT HELD DURING THE ANNUAL TOWN CELEBRATION. 409302 0 620974 INDEPENDENT SENIOR LIVING - ORCHARD ESTATES IS A 40-UNIT SENIOR HOUSING COMPLEX COMPRISED OF ONE- AND TWO- BEDROOM APARTMENTS. PUBLIC AREAS THAT SUPPORT CONNECTION AND COMMUNITY WERE RECENTLY REMODELED FOR TENANT USE. THE ON-SITE DIRECTOR PLANS ACTIVITIES OF INTEREST TO TENANTS AND ENCOURAGES INVOLVEMENT IN GLENCOE REGIONAL HEALTH ACTIVITIES AND VOLUNTEERING. 63412554 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 77 0 1 824 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 MN X ANGELA ERICKSON 3208643121 1805 HENNEPIN AVENUE NORTH GLENCOE MN 55336 SCOTT KUEHN CHAIR 0.50 0.00 X X 0 0 0 MARY STOLTENBURG VICE CHAIR 0.50 0.00 X X 0 0 0 HEATHER PEIRCE SECRETARY 0.50 0.00 X X 0 0 0 SEAN TRITABAUGH DIRECTOR 0.50 0.00 X 0 0 0 DR BRYAN FRITSCH DIRECTOR & PHYSICIAN 40.50 0.00 X 389035 0 49328 DR BRYAN PETERSEN DIRECTOR & PHYSICIAN 40.50 0.00 X 474567 0 53812 DR KRISTEN BUDAHN DIRECTOR & PHYSICIAN 40.50 0.00 X 640769 0 43436 ANGELA ERICKSON CFO 40.00 0.00 X 212261 0 45681 BENJAMIN DAVIS PRESIDENT AND CEO 40.00 0.00 X 372209 0 55274 DR CHAD ROBBINS PHYSICIAN 40.00 0.00 X 502729 0 49350 DR ELIZABETH COLSEN PHYSICIAN 40.00 0.00 X 535634 0 40036 DR KEN SMITH PHYSICIAN 40.00 0.00 X 525365 0 19992 JOSLIN THIEMANN APRN ADVANCED PRACTICE PROV. 40.00 0.00 X 806307 0 52209 DR MATTHEW COPPLE PHYSICIAN 40.00 0.00 X 888736 0 40685 5347612 0 449803 105 0 1 0 MA MORTENSON COMPANY PO BOX 857126 MINNEAPOLIS MN 554857126 CONSTRUCTION 1279745 PREMIER STAFFING INC 243 WINKLER TRAIL COLOGNE MN 55322 PHYSICIAN SERVICES 822282 BWBR ARCHITECTS INC 380 ST PETER ST LAWSON COMMONS 60 ST PAUL MN 551021996 ARCHITECT/ENGINEERING 642620 AYA HEALTHCARE INC PO BOX 674907 DALLAS TX 752674907 POOL/CONTRACT LABOR 632971 FOSTER MECHANICAL INC 945 5TH AVENUE SE UNIT 12 HUTCHINSON MN 553507040 CONSTRUCTION 553997 25 72401 229895 209059 511355 PATIENT SERVICE REVENU 621110 81371954 81371954 NURSING HOME 623000 14213674 14213674 SENIOR LIVING 623990 620974 620974 96206602 1951252 1951252 45065 0 45065 45065 45065 10280922 530 8849988 0 1430934 530 1431464 1431464 9117 10796 -1679 -1679 MISCELLANEOUS 900099 349686 349686 CAFETERIA REVENUE 722514 149719 149719 INVESTMENT IN JV 900099 30790 30790 530195 100674254 96206602 0 3956297 33011 33011 59865 59865 2336372 1634438 701934 49125193 37538884 11586309 1853928 1853928 5650134 5650134 3135276 2304599 830677 27687 27687 112891 112891 185194 185194 4411 4411 5323095 2548130 2774965 198824 198824 1300159 486453 813706 558294 558294 1921438 732587 1188851 180565 86845 93720 126623 17966 108657 675229 675229 4559107 4559107 990746 309913 680833 DRUGS 6443511 6435638 7873 MEDICAL EXPENSES 6004375 3148169 2856206 BAD DEBT EXPENSES 2176450 2176450 LICENSES AND TAXES 1556728 293328 1263400 1309691 371942 937749 95848797 63412554 32436243 0 7165317 8798441 15645792 15894709 13330746 13431861 625607 650605 1119822 1110975 124280999 76968396 47087060 47312603 43628218 49301628 4631 31999 2356582 3305126 130963775 139837947 7320621 7931633 319919 128938 19384861 17689858 24821 27258 2356582 4739982 29406804 30517669 X 101556971 109320278 101556971 109320278 130963775 139837947 4825457 2937850 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4411 4411 0 PART II-B, LINE 1: LOBBYING PORTION OF ASSOCIATION DUES PAID TO AHA AND MHA. 0 1 X 1285067 1285067 62255948 37425745 24830203 3029591 2152182 877409 55965958 37390469 18575489 1744435 1744435 47312603 DEFERRED COMPENSATION 2671609 THIRD PARTY PAYABLE 1434856 LEASE LIABILITY 633517 4739982 X 101323878 2937850 10796 2948646 98375232 2299022 2299022 100674254 93683143 10796 10796 93672347 2176450 2176450 95848797 PART IV, LINE 2B: INDEPENDENT SENIOR LIVING TENANTS MAKE SECURITY DEPOSITS WHEN THEY MOVE IN TO THE FACILITY. DEPOSITS, WITH INTEREST, LESS ANY COSTS OF REPAIRS, ARE RETURNED TO TENANTS OR THEIR ESTATES WHEN THE TENANT LEAVES THE FACILITY. THE ORGANIZATION HOLDS SMALL AMOUNTS DEPOSITED BY RESIDENTS OF THE NURSING HOME ON THEIR BEHALF. RESIDENTS MAY MAKE DEPOSITS OR WITHDRAWALS AT ANY TIME. PART X, LINE 2: THE FACILITY QUALIFIES AS A TAX-EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE FACILITY IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(C)(3) OF THE CODE. THE FACILITY FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 10,796. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,176,450. RESTRICTED CONTRIBUTIONS FOR PROPERTY AND EQUIPMENT 122,572. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 10,796. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,176,450. 1 1 X 1 X 1 X 0 1 1 0 0 1026838 1026838 0.01070 10799207 7702034 3097173 0.03230 11826045 7702034 4124011 0.04300 349896 12985 336911 0.00350 539273 52455 486818 0.00510 118859 118859 0.00120 1008028 65440 942588 0.00980 12834073 7767474 5066599 0.05280 239992 239992 0.00250 239992 239992 0.00250 1 2176450 20590384 20898979 -308595 X 1 1 1 1 GLENCOE REGIONAL HEALTH SERVICES 1805 HENNEPIN AVENUE NORTH GLENCOE MN 55336 WWW.GLENCOEHEALTH.ORG 360844 X X X X NURSING HOME/SNF GLENCOE REGIONAL HEALTH SERVICES 1 0 0 1 X X X X X X X X X 25 1 0 1 1 X SEE PART V, SECTION B, LINE 7D X X 1 25 1 SEE PART V, SECTION B, LINE 7D 0 1 X 200.000000000000 400.000000000000 X 1 1 X X X 1 X SEE PAGE V, LINE 16J X SEE PAGE V, LINE 16J X SEE PAGE V, LINE 16J X X X X X X 1 X 0 X X X 1 X 0 0 GLENCOE REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 5: IN 2025, GLENCOE REGIONAL HEALTH (GRH) PARTNERED WITH CLIFTONLARSONALLEN TO BEGIN ITS NEW CHNA PROCESS. CLIFTONLARSONALLEN REPRESENTATIVES CONDUCTED ONE-ON-ONE INTERVIEWS WITH A VARIETY OF KEY STAKEHOLDERS. IN DOING SO, EACH INDIVIDUAL WAS ASKED THE SAME SERIES OF OPEN-ENDED QUESTIONS DURING A 30-60-MINUTE VIRTUAL OR IN-PERSON INTERVIEW. KEY STAKEHOLDERS PROVIDING INPUT INCLUDED THE FOLLOWING: GRH BOARD MEMBERS SCOTT KUEHN, HEATHER PEIRCE, MARY STOLTENBURG, AND SEAN TRITABAUGH; 2B CONTINUED; GLENCOE POLICE DEPARTMENT; GLENCOE-SILVER LAKE SCHOOL DISTRICT; INTEGRATIONS WELLNESS & RECOVERY CENTER; MCLEOD COUNTY HEALTH AND HUMAN SERVICES; MCLEOD FOOD SHELF; TOGETHER WE ARE GLENCOE; UNITED COMMUNITY ACTION PARTNERSHIP; AND WINSTED/LESTER PRAIRIE POLICE DEPARTMENT. IN ADDITION, 14 GRH PHYSICIANS AND FOUR EMPLOYEES RESPONSIBLE FOR CLINICAL AREAS WERE INTERVIEWED. EACH INTERVIEW WAS SUMMARIZED, AND THEMES EMERGED. GRH SENIOR LEADERSHIP DISCUSSED THE FINDINGS AND PRIORITIZED COMMUNITY HEALTH NEEDS GOING FORWARD: OBESITY AND BEHAVIORAL HEALTH INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE, WHICH ARE SIMILAR TO PREVIOUS CHNA RESULTS. AN IMPLEMENTATION STRATEGY WAS DEVELOPED USING THESE HEALTH NEEDS AND THE INPUT PROVIDED BY ALL STAKEHOLDERS. GLENCOE REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 6B: THE NON-HOSPITAL ORGANIZATIONS INVOLVED IN THE ASSESSMENT PROCESS INCLUDED REPRESENTATIVES FROM MCLEOD COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES, CITY OF GLENCOE, CITY OF STEWART, GLENCOE SCHOOL DISTRICT, GLENCOE POLICE DEPARTMENT, GLENCOE CHAMBER OF COMMERCE, LORENZ CLINIC, SECURITY BANK & TRUST, ALLINA HEALTH (AMBULANCE SERVICES), AND INTEGRATIONS WELLNESS & RECOVERY CENTER, AS WELL AS UNAFFILIATED COMMUNITY MEMBERS. GLENCOE REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 7D: THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT: HTTPS://GLENCOEHEALTH.ORG/OUR-ORGANIZATION/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/DIRECT LINK:HTTPS://GLENCOEHEALTH.ORG/WP-CONTENT/UPLOADS/2025/10/2025-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF GLENCOE REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 11: IN RESPONSE TO THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH ITS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), GLENCOE REGIONAL HEALTH ADOPTED AN IMPLEMENTATION STRATEGY FOCUSED ON BEHAVIORAL HEALTH (INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE) AND OBESITY. TO ADDRESS BEHAVIORAL HEALTH NEEDS, THE ORGANIZATION PLANS TO EXPLORE EXPANSION OF IN-HOUSE MENTAL HEALTH SERVICES, CONTINUE ITS MEDICAL DIRECTORSHIP AND PARTNERSHIPS WITH INTEGRATIONS WELLNESS & RECOVERY CENTER, STRENGTHEN SUBSTANCE ABUSE EDUCATION FOR PROVIDERS, COLLABORATE WITH COMMUNITY ORGANIZATIONS SUCH AS 2B CONTINUED AND MCLEOD EDUCATION AND DRUG AWARENESS (MEADA), AND INCREASE COMMUNITY AWARENESS OF AVAILABLE MENTAL HEALTH RESOURCES THROUGH OUTREACH, EDUCATION, AND FINANCIAL SUPPORT. TO ADDRESS OBESITY, THE ORGANIZATION PLANS TO MAINTAIN AND ENHANCE PATIENT EDUCATION EFFORTS, PROMOTE EMPLOYEE WELLNESS INITIATIVES, STRENGTHEN COMMUNITY PARTNERSHIPS, PROVIDE COMMUNITY EDUCATION REGARDING HEALTHY LIFESTYLES AND CHRONIC DISEASE PREVENTION, IMPROVE ACCESS TO HEALTHY FOODS THROUGH COLLABORATION WITH ORGANIZATIONS SUCH AS THE MCLEOD FOOD SHELF AND LOCAL FARMERS MARKET, AND CONTINUE INVESTMENTS IN COMMUNITY PHYSICAL ACTIVITY RESOURCES, INCLUDING PRAIRIE TRAIL. THE IMPLEMENTATION STRATEGY WAS DEVELOPED TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH INTERVIEWS WITH COMMUNITY STAKEHOLDERS AND ANALYSIS OF COMMUNITY HEALTH DATA. GLENCOE REGIONAL HEALTH SERVICES PART V, SECTION B, LINE 16J: EACH SELF-PAY EMERGENCY DEPARTMENT PATIENT RECEIVES A LIST OF MNSURE NAVIGATORS AND ARE ASKED TO SIGN A SELF-PAY DISCLAIMER. WITHIN 30 DAYS OF THEIR VISIT OR DISCHARGE GRH STAFF WILL CALL SELF-PAY PATIENTS TO ENSURE THEY ARE AWARE OF THE DISCOUNTS AVAILABLE TO THEM. IN ADDITION, THE FINANCIAL ASSISTANCE APPLICATION WILL BE MAILED TO THEIR ADDRESS ON FILE. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT:HTTPS://GLENCOEHEALTH.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/DIRECT LINK:HTTPS://GLENCOEHEALTH.ORG/WP-CONTENT/UPLOADS/2026/01/FINANCIAL-ASSISTANCE-POLICY-2026.PDFTHE FINANCIAL ASSISTANCE POLICY APPLICATION IS AVAILABLE AT:HTTPS://GLENCOEHEALTH.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/DIRECT LINK: HTTPS://GLENCOEHEALTH.ORG/WP-CONTENT/UPLOADS/2026/01/2026-MEDICAL-DISCOUNT-APP.PDFTHE FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://GLENCOEHEALTH.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/DIRECT LINK:HTTPS://GLENCOEHEALTH.ORG/WP-CONTENT/UPLOADS/2025/02/2025-GRH-PLAIN-LANGUAGE-SUMMARY-OF-FINANCIAL-ASSISTANCE-POLICY.PDF 4 1 - GLENFIELDS LIVING WITH CARE 2015 HENNEPIN AVENUE NORTH GLENCOE MN 55336 NURSING HOME 2 - GLENCOE REGIONAL HEALTH SERVICES 1024 CENTRAL AVENUE LESTER PRAIRIE MN 55354 CLINIC 3 - GLENCOE REGIONAL HEALTH SERVICES 300 BOWMAN STREET STEWART MN 55385 CLINIC 4 - ORCHARD ESTATES 1900 FORD AVENUE NORTH GLENCOE MN 55336 SENIOR APARTMENTS PART I, LINE 3C: ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON HOUSEHOLD INCOME, FAMILY SIZE, AND OTHER AVAILABLE FINANCIAL RESOURCES. APPLICANTS MUST SUBMIT A FINANCIAL ASSISTANCE APPLICATION AND SUPPORTING INCOME DOCUMENTATION. FREE OR DISCOUNTED CARE IS AVAILABLE TO QUALIFYING INDIVIDUALS BASED ON THE FEDERAL POVERTY GUIDELINES. PART I, LINE 7: THE AMOUNTS IN PART I, LINE 7 WERE CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE IRS INSTRUCTIONS TO FORM 990, SCHEDULE H. PART I, LINE 7G: THE ORGANIZATION DID NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC IN ITS SUBSIDIZED HEALTH SERVICES IN SCHEDULE H, PART I, LINE 7G. PART I, LN 7 COL(F): BAD DEBT EXPENSE - REPORTED IN FORM 990, PART IX, LINE 24 - IS SUBTRACTED FROM THE TOTAL FUNCTIONAL EXPENSES IN CALCULATING THE PERCENTAGES IN PART 1, LINE 7, COLUMN F. BAD DEBT EXPENSE SUBTRACTED IN THIS WAY WAS $2,176,450 FOR 2025. PART II, COMMUNITY BUILDING ACTIVITIES: OUR COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF OUR COMMUNITIES THROUGH DISASTER PREPAREDNESS EFFORTS, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PATIENTS, FINANCIAL AND IN-KIND SUPPORT, AND EDUCATION. FIRST, THROUGH DISASTER PREPAREDNESS TRAINING, WE SUPPORT AND PROTECT THE HEALTH OF OUR COMMUNITIES BY WORKING TO INSURE THAT THOSE NEEDING MEDICAL ATTENTION CAN ACCESS QUALITY CARE IN A SAFE AND TIMELY MANNER. DISASTER PREPAREDNESS EFFORTS ARE A YEAR-ROUND ACTIVITY, AS DISASTERS CAN INCLUDE PANDEMICS, NATURAL DISASTERS AND MASS CASUALTY SITUATIONS. SECOND, BY PROVIDING CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PATIENTS, WE WORK TO HELP PATIENTS RETURN HOME AND REGAIN THEIR INDEPENDENCE AFTER AN ILLNESS, INJURY OR SURGERY. IN CASES WHERE IT IS NOT POSSIBLE FOR SOMEONE TO RETURN HOME, WE WORK TO MAKE SURE THEY HAVE ACCESS TO THE CARE AND RESOURCES THEY NEED TO CONTINUE THEIR RECOVERY OR LIVE WITH DIGNITY. THROUGH HELPING OUR PATIENTS OBTAIN FINANCIAL SUPPORT, AS WELL AS OBTAIN ACCESS TO COMMUNITY SUPPORT SYSTEMS, WE WORK TO ENSURE THAT THEY GET ADDITIONAL SERVICES THAT MAY BE NEEDED TO ASSIST IN THEIR RECOVERY. THIS PROMOTES THE HEALTH OF THE COMMUNITY BY ENSURING THAT PATIENTS HAVE THE SUPPORT AND RESOURCES THEY NEED TO RETURN TO THE COMMUNITY AS PRODUCTIVE CITIZENS, AS WELL AS HELPING TO CREATE A COMMUNITY IN WHICH PEOPLE ARE VALUED AND TREATED WITH RESPECT.THIRD, BY PROVIDING FINANCIAL AND IN-KIND SUPPORT TO THE GLENCOE AREA CHAMBER OF COMMERCE, WE SUPPORT THE ECONOMIC HEALTH OF OUR REGION. A STRONG LOCAL ECONOMY CONTRIBUTES TO THE OVERALL HEALTH AND WELL-BEING OF ALL ITS RESIDENTS. BY PROVIDING FINANCIAL AND IN-KIND SUPPORT FOR COMMUNITY ACTIVITIES, SUCH AS THE MCLEOD COUNTY FOOD DRIVE CHALLENGE, WE ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY.FINALLY, BY PROVIDING EDUCATIONAL PRESENTATIONS AND TOURS TO OUR AREA SCHOOLS, WE ARE INVESTING IN A FUTURE GENERATION OF HEALTH CARE WORKERS WHO MAY PROVIDE DIRECT CARE TO OUR PATIENTS AND OTHERS IN THE COMMUNITIES WE SERVE. WE ARE ALSO EDUCATING INDIVIDUALS ABOUT THE WORK WE DO, WHY WE DO IT, AND HOW OUR EFFORTS AFFECT THEIR LIVES AND THE LIVES OF OTHERS. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, GRHS ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, GRHS ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, GRH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY FOR THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 3: GRHS IS UNABLE TO REASONABLY CALCULATE THE AMOUNT OF ITS BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE IF THEY APPLIED. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLE AND ALLOWANCE FOR CREDIT LOSSES" PARAGRAPH IN NOTE 1 ON PAGE 8 TO THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE ORGANIZATION USES A COST-TO-CHARGE RATIO TO CALCULATE THE MEDICARE ALLOWABLE COSTS REPORTED IN ITS MEDICARE COST REPORT. THE ORGANIZATION USES THE MEDICARE REIMBURSEMENT PROVIDER MANUAL 15-2 TO DETERMINE ACCEPTABLE METHODOLOGIES. AS A NONPROFIT HOSPITAL, GRHS RECOGNIZE THAT MEDICARE SHORTFALLS CAN CREATE FINANCIAL PRESSURE. HOWEVER, CONSISTENT WITH IRS GUIDANCE AND INDUSTRY PRACTICE, GRHS DO NOT CONSIDER MEDICARE SHORTFALL AS PART OF OUR COMMUNITY BENEFIT CALCULATION, AS MEDICARE IS NOT A MEANS-TESTED PROGRAM. OUR COMMUNITY BENEFIT REPORTING REMAINS FOCUSED ON PROGRAMS AND SERVICES THAT DIRECTLY SUPPORT VULNERABLE AND UNDERSERVED POPULATIONS. PART III, LINE 9B: ALL PATIENTS WILL RECEIVE MONTHLY STATEMENTS FOR ALL OUTSTANDING BALANCES. EACH STATEMENT WILL INCLUDE A SUMMARY OF CHARGES, PAYMENTS, ADJUSTMENTS, AND THE CURRENT BALANCE DUE. IF NO PAYMENTS ARE MADE AFTER THE SECOND STATEMENT HAS BEEN SENT, THE PATIENT WILL BE CALLED. IF NO RESPONSE, A FINAL LETTER IS SENT NOTIFYING THE PATIENT THE ACCOUNT WILL BE SENT TO COLLECTIONS IN 30 DAYS. PAYMENT PLANS ARE AVAILABLE TO ALL PATIENTS REGARDLESS OF INSURANCE COVERAGE OR FINANCIAL SITUATION. WE DO NOT CHARGE INTEREST OR FEES ON PAYMENT PLANS.IF PATIENTS CONTACT US ABOUT THEIR BILL, WE WILL REFER THEM TO FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE OR DETERMINE IF THEY ARE ELIGIBLE FOR CHARITY CARE PROGRAMS OR UNINSURED DISCOUNT PROGRAMS. INFORMATION ABOUT THE DISCOUNTS AND PROGRAMS THAT ARE AVAILABLE TO PATIENTS CAN ALSO BE FOUND ON THE BACK OF EACH MONTHLY STATEMENT, ON GRHS WEBSITE AND ON EACH PAYMENT REMINDER LETTER THAT IS SENT. WHEN INSURANCE COMPANIES NEED MORE INFORMATION FROM THE PATIENT TO PROCESS THE CLAIM, WE WILL CALL THE PATIENT AND SEND THE PATIENT A REMINDER LETTER ASKING THE PATIENT TO CONTACT THEIR INSURANCE COMPANY. PART VI, LINE 2: GHRS HAS CONDUCTED COMMUNITY-BASED RESEARCH ON SEVERAL OCCASIONS, INCLUDING USE OF FOCUS GROUPS AND STATISTICALLY VALID TELEPHONIC SURVEYS. DURING STRATEGIC PLANNING PROCESSES, DEMOGRAPHIC AND UTILIZATION TRENDS ARE REVIEWED, ALONG WITH THE RESULTS OF ANY COMMUNITY-BASED RESEARCH. FEEDBACK FROM MEDICAL STAFF MEMBERS IS SOLICITED REGARDING TRENDS AND ISSUES THEY SEE. PATIENT FEEDBACK FROM PATIENT SURVEYS IS ALSO REVIEWED. PART VI, LINE 3: NOTIFICATION ABOUT FINANCIAL ASSISTANCE FROM GLENCOE REGIONAL HEALTH WILL BE DISSEMINATED BY VARIOUS MEANS, WHICH INCLUDE, BUT ARE NOT LIMITED TO:- PUBLICATION OF NOTICES IN ADMITTING AND PATIENT ACCESS DEPARTMENTS, PATIENT FINANCIAL ADVOCATE OFFICE, AND EMERGENCY ROOM.- PROVIDING NOTIFICATION ON BILLING STATEMENTS.- POSTING OF INFORMATION, INCLUDING POLICIES, APPLICATIONS AND PLAIN LANGUAGE SUMMARIES ON OUR PUBLIC WEBSITE, GLENCOEHEALTH.ORG.- PATIENTS WILL RECEIVE A PRINTED COPY OF THE PLAIN LANGUAGE SUMMARY UPON DISCHARGE FROM THE HOSPITAL IN OBSERVATION AND INPATIENT STATUSES.- ALL GLENCOE REGIONAL HEALTH EMPLOYEES WHO HAVE DIRECT CONTACT WITH PATIENTS WILL BE EDUCATED ON AN ANNUAL BASIS OF THE FINANCIAL ASSISTANCE POLICY. THIS WILL INCLUDE THE EXISTENCE OF THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AND HOW A PATIENT MAY OBTAIN MORE INFORMATION AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE.- DURING THE PRE-REGISTRATION, REGISTRATION, OR ADMISSION PROCESS, GLENCOE REGIONAL HEALTH WILL ATTEMPT TO IDENTIFY ALL THIRD-PARTY PAYERS THAT MAY BE OBLIGATED TO PAY FOR SERVICES PROVIDED TO A PATIENT; AND ATTEMPT TO EDUCATE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: GLENCOE REGIONAL HEALTH SERVES A PREDOMINANTLY RURAL POPULATION IN MCLEOD COUNTY AND PORTIONS OF SIBLEY AND RENVILLE COUNTIES IN MINNESOTA. THE SERVICE AREA INCLUDES A HIGHER PROPORTION OF RESIDENTS AGE 65 AND OLDER THAN THE STATE AVERAGE AND IS LESS RACIALLY AND ETHNICALLY DIVERSE THAN MINNESOTA OVERALL, ALTHOUGH THE HISPANIC POPULATION EXCEEDS THE STATE AVERAGE. MEDIAN HOUSEHOLD INCOME IS BELOW THE STATE AVERAGE, EDUCATIONAL ATTAINMENT IS LOWER, AND APPROXIMATELY 7.7% OF RESIDENTS LIVE IN POVERTY. THE COMMUNITY ALSO HAS A SLIGHTLY HIGHER PERCENTAGE OF INDIVIDUALS WITH DISABILITIES THAN MINNESOTA OVERALL. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 2B CONTINUED PO BOX 24 GLENCOE MN 55336 842398238 501(C)(3) 7500 0 N/A N/A GENERAL SUPPORT 1 0 NAR TRAINING PROGRAM 49 33605 0 N/A N/A TUITION REIMBURSEMENT 8 26260 0 N/A N/A PART I, LINE 2: THE ORGANIZATION PROVIDES TUITION REIMBURSEMENT ASSISTANCE TO EMPLOYEES. EMPLOYEES ARE REQUIRED TO COMPLETE THE REIMBURSEMENT REQUEST FORM, WHICH IS TO BE SIGNED BY THEIR SUPERVISOR, PRIOR TO BEGINNING THEIR COURSE(S) TO RESERVE FUNDS. THEY ARE TO INCLUDE A DESCRIPTION OF THE COURSE(S) THEY PLAN TO TAKE, AND RECEIPTS FOR TUITION AND BOOKS, (FEES ARE NOT ELIGIBLE FOR REIMBURSEMENT), WITH THEIR REQUEST. EMPLOYEES ARE REQUIRED TO COMPLETE THEIR COURSE WITH A GRADE OF C OR BETTER TO BE ELIGIBLE FOR REIMBURSEMENT. EMPLOYEES ARE RESPONSIBLE FOR ALL UP-FRONT COSTS. THE ORGANIZATION PROVIDES A NAR TRAINING PROGRAM WHERE THE ORGANIZATION WILL PAY FOR ALL TRAINING AND TESTING FOR CANDIDATES TO RECEIVE A NAR CERTIFICATION WHICH IS MANAGED BY AN EDUCATION SPECIALIST. CANDIDATES ARE INTERVIEWED AND HIRED INTO THE PROGRAM WHERE THEY COMPLETE ALL NECESSARY TRAINING. ONCE ALL TRAINING IS COMPLETED THE EDUCATION SPECIALIST COORDINATES THE TESTING THROUGH QUALIFIED INSTITUTIONS AND APPROVES THE PAYMENTS TO THESE INSTITUTIONS AS THE EMPLOYEES COMPLETE THE TESTING. ANY DONATION GREATER OR EQUAL TO $5,000 MUST BE REVIEWED AND APPROVED BY THE CHIEF DEVELOPMENT OFFICER. X X X 0 0 0 0 0 0 0 0 0 DR MATTHEW COPPLE PHYSICIAN 817605 0 28826 0 42305 0 17300 0 23385 0 929421 0 0 0 JOSLIN THIEMANN APRN ADVANCED PRACTICE PROV. 767078 0 28873 0 10356 0 17300 0 34909 0 858516 0 0 0 DR KRISTEN BUDAHN DIRECTOR & PHYSICIAN 640769 0 0 0 0 0 17183 0 26253 0 684205 0 0 0 DR ELIZABETH COLSEN PHYSICIAN 520835 0 1854 0 12945 0 17300 0 22736 0 575670 0 0 0 DR CHAD ROBBINS PHYSICIAN 502729 0 0 0 0 0 17300 0 32050 0 552079 0 0 0 DR KEN SMITH PHYSICIAN 511557 0 0 0 13808 0 14776 0 5216 0 545357 0 0 0 DR BRYAN PETERSEN DIRECTOR & PHYSICIAN 474567 0 0 0 0 0 17300 0 36512 0 528379 0 0 0 DR BRYAN FRITSCH DIRECTOR & PHYSICIAN 389035 0 0 0 0 0 14056 0 35272 0 438363 0 0 0 BENJAMIN DAVIS PRESIDENT AND CEO 339491 0 32718 0 0 0 17500 0 37774 0 427483 0 0 0 ANGELA ERICKSON CFO 212261 0 0 0 0 0 11108 0 34573 0 257942 0 0 0 A CITY OF GLENCOE MINNESOTA 416005185 378160BW4 2013-02-27 23087781 DEFEASE SERIES 2005 BONDS 0 0 0 B CITY OF PLATO MINNESOTA 416005465 72766SAM3 2017-05-18 10938562 PROVIDE FUNDING FOR THE CONSTRUCTION OF THE EXPANSION OF THE NURSING HOME 0 0 0 A 13090000 23087781 1737800 388068 20961913 2013 1 0 1 1 B 2225000 10938562 716513 218771 10003278 2017 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF GLENCOE, MINNESOTA DATE THE REBATE COMPUTATION WAS PERFORMED: 01/11/2023 ISSUER NAME: CITY OF PLATO, MINNESOTA DATE THE REBATE COMPUTATION WAS PERFORMED: 01/11/2023 FORM 990, PART VI, SECTION A, LINE 1A THERE SHALL BE AN EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS WHICH SHALL CONSIST OF THE CHAIRPERSON OF THE BOARD OF DIRECTORS, THE VICE CHAIRPERSON OF THE BOARD OF DIRECTORS, THE PRESIDENT AND THE SECRETARY OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL ADVISE WITH AND AID THE OFFICERS OF THE CORPORATION IN ALL MATTERS CONCERNING THE MANAGEMENT OF ITS BUSINESS; AND BETWEEN MEETINGS OF THE BOARD OF DIRECTORS THE EXECUTIVE COMMITTEE SHALL POSSESS AND MAY EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS EXCEPT WITH REFERENCE TO MAKING OR AMENDING THE BYLAWS FOR THE BOARD OF DIRECTORS, REMOVING ANY MEMBER OF THE BOARD OF DIRECTORS OR FILLING VACANCIES IN THEIR OWN MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAD A CONTRACTUAL ARRANGEMENT WITH PARK NICOLLET HEALTH SERVICES THROUGH 2019, UNDER WHICH PARK NICOLLET HEALTH SERVICES (PNHS) PROVIDED A CHIEF EXECUTIVE OFFICER, MANAGEMENT CONSULTATION, AND OTHER SERVICES TO THE FACILITY. THE ARRANGEMENT DID NOT ALTER THE AUTHORITY OR RESPONSIBILITY OF THE BOARD OF DIRECTORS OF GLENCOE REGIONAL HEALTH SERVICES. STARTING IN 2020, THE CONTRACTUAL AGREEMENT WITH PHNS WAS AMENDED WHERE THE CEO IS EMPLOYED DIRECTLY BY THE ORGANIZATION, AND PNHS WILL PROVIDE MANAGEMENT AND OTHER SERVICES TO THE FACILITY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED WITH THE BOARD MEMBERS AT A REGULARLY SCHEDULED BOARD MEETING. THE BOARD WAS ASKED TO APPROVE THE DOCUMENT PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C GLENCOE REGIONAL HEALTH SERVICES HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL MEMBERS OF THE BOARD OF DIRECTORS, MEMBERS OF A COMMITTEE OF THE BOARD OF DIRECTORS, AND SENIOR MANAGEMENT. ANNUALLY, THE BOARD MEMBERS AND SENIOR MANAGEMENT ARE ASKED TO COMPLETE A CONFLICT OF INTEREST DECLARATION. ANY INDIVIDUAL HAVING A CONFLICT OF INTEREST IS REQUIRED TO INFORM THE BOARD OR COMMITTEE. THE INDIVIDUAL ABSTAINS FROM VOTING ON THE MATTER, BUT IS PERMITTED TO BRIEFLY STATE THEIR POSITION AND ANSWER PERTINENT QUESTIONS. THE MINUTES OF THE MEETING REFLECT THAT THE DISCLOSURE WAS MADE AND THAT THE PERSON ABSTAINED FROM VOTING. THE PRESIDENT AND CEO IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION REVIEW PROCESS IS PERFORMED BY THE BOARD OF DIRECTORS. THE BOARD USES FORM 990 INFORMATION FROM OTHER COMPARABLE ORGANIZATIONS ALONG WITH COMPENSATION BENCHMARKING DATA FROM THE MINNESOTA HOSPITAL ASSOCIATION, THE MEDICAL GROUP MANAGEMENT ASSOCIATION MARKET DATA, AND THE HEALTHCARE HUMAN RESOURCES ASSOCIATION OF MINNESOTA TO GATHER COMPARISON DATA. ANNUALLY, THIS DATA AND THE PERFORMANCE REVIEW DONE BY THE BOARD OF DIRECTORS ARE USED TO SET THE CEO'S COMPENSATION. THE MOST RECENT YEAR THIS PROCESS WAS CONDUCTED WAS IN 2025. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. GLENCOE REGIONAL HEALTH SERVICES FOUNDATION INC 1805 HENNEPIN AVE N GLENCOE MN 55336 411625505 FUNDRAISING MN 501(C)(3) LINE 12C, III-FI N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0