2026-08-13T16:06:05-05:00 2025-09-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2024-10-01 410785161 MILLE LACS HEALTH SYSTEM MILL 3205322581 200 NORTH ELM STREET PO BOX A ONAMIA MN 563590800 ANDREW KNUTSON CEO 3205322581 2026-08-10 1 0 JUSTIN HARTERT P02236744 5074467100 2026-08-10 2024 2025-03-06 01:10:19Z ANDREW KNUTSON 200 NORTH ELM STREET PO BOX A ONAMIA MN 563590800 74520370 0 X WWW.MLHEALTH.ORG X 1953 MN TO PROVIDE QUALITY HEALTH SERVICES TO RESIDENTS OF ONAMIA, MN AND THE SURROUNDING AREA. 12 6 559 40 -485485 0 817334 5655320 61751201 67521011 308968 329890 655032 1006595 63532535 74512816 0 0 0 0 33884366 34860556 0 0 0 30873009 39869443 64757375 74729999 -1224840 -217183 57778960 56264654 40177810 38559014 17601150 17705640 X TO ASSIST THOSE RESIDING IN AND VISITING THE MILLE LACS AREA IN ACHIEVING AND MANTAINING OPTIMAL HEALTH. 0 0 65963092 0 67521011 MILLE LACS HEALTH SYSTEM (MLHS) IS A RURAL HEALTH SYSTEM LOCATION IN ONAMIA, MN, 80 MILES NORTH OF THE TWIN CITIES AREA NEAR LAKE MILLE LACS. OUR SYSTEM INCLUDES A 18-BED ACUTE CARE HOSPITAL, A 57-BED LONG-TERM CARE FACILITY, A 10-BED SENIOR CARE FACILITY, HOME CARE, HOSPICE, A BLS AND ALS AMBULANCE SERVICE, AS WELL AS AN ATTACHED MEDICAL CLINIC. MLHS ALSO OPERATES MEDICAL CLINICS IN THE TOWNS OF ISLE, HILLMAN, GARRISON, AND MILACA. OUR MEDICAL STAFF ALSO PROVIDES COVERAGE TO THE NE-IA-SHING CLINIC ON THE NEARBY MILLE LACS RESERVATION. THE HEALTH SYSTEM IS ORGANIZED AS A 501(C)(3) NONPROFIT CORPORATION. DUE TO THE LACK OF AVAILABLE HEALTHCARE OPTIONS IN THIS CENTRAL MINNESOTA REGION, THE FEDERAL GOVERNMENT HAS DESIGNATED THIS COMMUNITY AS A MEDICALLY UNDERSERVED AREA IN TERMS OF PRIMARY CLINICS.THE REMOTENESS OF HEALTHCARE SERVICES TO THE MILLE LACS COMMUNITIES IN THE 1950'S PROMPTED AN AREA-WIDE COMMUNITY EFFORT TO BUILD A HOSPITAL. THE HOSPITAL WAS COMPLETED IN 1956 AND, FIVE YEARS LATER A NURSING HOME WAS BUILT ADJACENT TO IT. OVER THE YEARS, THE FACILITIES HAVE BEEN EXPANDED AND MODERNIZED AND RENAMED SEVERAL TIMES. IN 1995, AN AMBITIOUS BUILDING PROJECT AND INTEGRATION EFFORT, WHICH INCLUDED A NEW HOSPITAL EMERGENCY ROOM, REHABILITATION CENTER, AND CLINIC SPACE WERE COMPLETED. THIS BUILDING PROJECT WAS MADE POSSIBLE THROUGH NEARLY A HALF MILLION DOLLARS WHICH WERE RAISED LOCALLY. IN 2001, A MULTI-MILLION DOLLAR EXPANSION AND RENOVATION PROJECT WAS STARTED TO FURTHER UPGRADE THE HOSPITAL AND LONG-TERM CARE SERVICES AND POSITION US TO MEET THE GROWING HEALTHCARE NEEDS OF THE AREA.MILLE LACS HEALTH SYSTEM SERVES A PERMANENT POPULATION BETWEEN 15,000 AND 20,000, INCLUDING RESIDENTS OF THE MILLE LACS RESERVATION. BECAUSE OF THE RECREATIONAL FEATURES OF THE MILLE LACS AREA, MLHS ALSO SERVES A NUMBER OF SEASONAL RESIDENTS. IT IS ESTIMATED THAT DURING THE BUSY SUMMER AND HOLIDAY WEEKEND THERE ARE UP TO AN ADDITIONAL 25,000 PEOPLE IN THE AREA. THIS NUMBER IS BASED ON STATISTICS FROM LOCAL RESORTS, MOTELS, AND CAMPGROUNDS. THE CLOSEST ACUTE CARE FACILITY IS 28 MILES AWAY IN PRINCETON. THE CLOSEST TERTIARY CARE FACILITY IS 55 MILES AWAY IN ST. CLOUD. THE CLOSEST SECONDARY LEVEL IS 50 MILES AWAY IN BRAINERD. MLHS IS THE ONLY PROVIDER OF ACUTE CARE WITHIN OUR PRIMARY SERVICE AREA OF ONAMIA, HILLMAN, ISLE, GARRISON, AND WAHKON, WHICH INCLUDES THE MILLE LACS RESERVATION.MILLE LACS HEALTH SYSTEM ALSO SERVES PATIENTS OUTSIDE THE PRIMARY SERVICES AREA. THE SECONDARY SERVICE AREA INCLUDES MORA, BOCK, MILACA, AND OGILVIE. 65963092 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 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 93 0 1 559 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 6 1 0 0 0 0 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 MN X AMY NINHAM 3205322620 200 N ELM STR ONAMIA MN 56359 DR ARDEN VIRNIG DIRECTOR/PHYSICIAN 40.00 0.00 X 210899 0 51487 ANTHONY HASS DIRECTOR/CHIROPRACTOR 40.00 0.00 X 119804 0 27794 PHIL GRAVEL BOARD CHAIR 8.00 0.00 X X 4800 0 0 BETSY LUNDQUIST DIRECTOR 2.00 0.00 X 870 0 0 ROGER TRAMM DIRECTOR/TREASURER 2.00 0.00 X X 810 0 0 ROB DUBBS VICE CHAIR 2.00 0.00 X X 660 0 0 DENNIS BURR DIRECTOR 2.00 0.00 X 600 0 0 TRACY SAM DIRECTOR 2.00 0.00 X 450 0 0 JEAN STAFFORD SECRETARY 2.00 0.00 X X 420 0 0 SHANNON COYLE DIRECTOR 2.00 0.00 X 180 0 0 ROBERT ATHMAN DIRECTOR 2.00 0.00 X 90 0 0 JAMES STOTT DIRECTOR 2.00 0.00 X 0 0 0 WILLIAM NELSON CEO/CONSULTANT 40.00 0.00 X 450524 0 76820 ANDY KNUTSON CEO 40.00 0.00 X 199845 0 20486 JACKIE ULSETH CNO 40.00 0.00 X 193007 0 38533 BECKY FOSSAND CAO 40.00 0.00 X 188173 0 38310 AMY NINHAM CFO 40.00 0.00 X 146739 0 48179 DR PATTI HOOK-VIRNIG VP MEDICAL AFFAIRS 40.00 0.00 X 206881 0 50870 JAMES YOUNG HOSPITALIST 40.00 0.00 X 479056 0 13040 EARLE MUNNS HOSPITALIST 40.00 0.00 X 364600 0 64553 FAHAD KHEMANI PHYSICIAN 40.00 0.00 X 298817 0 27847 REBECCA MUWANSE PHYSICIAN 40.00 0.00 X 298253 0 29462 RYAN FOX PHYSICIAN 40.00 0.00 X 290138 0 41398 3455616 0 528779 68 0 1 0 CARDINAL HEALTH PO BOX 70539 CHICAGO IL 60673 HEALTHCARE SUPPLIES 5941283 FOCUS ONE PO BOX 850861 MINNEAPOLIS MN 55485 CONTRACTED LABOR- NURSING SERVICES 3381903 CENTRAL MN DIAGNOSTICS INC PO BOX 64756 ST PAUL MN 55164 RADIOLOGY SERVICES 1068059 MEDHOST PO BOX 201650 DALLAS TX 75320 IT SERVICES 703230 DIAGNOSTIC IMAGING SPECIALISTS 23294 DUTCHMANS BLUFF NISSWA MN 56468 RADIOLOGY SERVICES 642562 32 5236305 419015 5655320 PATIENT REVENUE 621110 61777783 61777783 CLINIC REVENUE 621110 4328920 4814405 -485485 ASSISTED LIVING 623000 1045979 1045979 JOINT VENTURE INCOME 621500 367496 367496 THERAPY REVENUE 621300 833 833 67521011 254667 254667 29920 0 29920 29920 29920 82777 7554 75223 75223 75223 48123 0 48123 48123 MEALS REVENUE 722310 442802 442802 MISCELLANEOUS 812900 292386 292386 JOINT VENTURE INCOME - OTHER 621500 153523 153523 39841 39841 928552 74512816 68006496 -485485 1336485 X 1515545 754583 760962 26470761 24621275 1849486 544961 544961 4394488 4394488 1934801 1756556 178245 74590 74590 894204 894204 10809000 8067342 2741658 225955 57042 168913 1311115 886033 425082 937272 914062 23210 232034 203589 28445 6869 6869 935895 907841 28054 3276058 3031716 244342 509707 217689 292018 MEDICAL SUPPLIES 15594333 15594333 BAD DEBT EXPENSE 2726421 2726421 FOOD 680235 680235 TAXES 357391 98282 259109 1298364 499775 798589 74729999 65963092 8766907 0 973663 4626557 4773677 5241427 11154084 8494824 646000 840000 1071668 937410 948431 578925 77446879 43803891 36211402 33642988 129682 99792 1235277 1248592 336810 224538 298266 329601 57778960 56264654 4086142 3531504 6353550 5948197 167195 -67 29411285 28609667 159638 469713 40177810 38559014 X 17429971 17302353 171179 403287 17601150 17705640 57778960 56264654 X -217183 333960 -12287 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2867 2867 0 PART II-B, LINE 1: THE ORGANIZATION PAYS ANNUAL DUES TO AHA/MHA/MHCA, OF WHICH, A PORTION IS SPENT ON LOBBYING. 0 1 X 1180310 1180310 53472671 27110460 26362211 3789362 1465203 2324159 19004536 15228228 3776308 33642988 DUE TO/FROM MEDICARE 367435 ROU LEASE LIABILITIES 102278 469713 X 72120355 333960 333960 71786395 2726421 2726421 74512816 72003578 0 72003578 2726421 2726421 74729999 PART IV, LINE 2B: THE HOSPITAL HOLDS FUNDS ON BEHALF OF THE NURSING HOME RESIDENTS IN A SEPARATE BANK ACCOUNT. PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 2,726,421. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 2,726,421. 1 1 X 1 X 1 X 1 1 1 0 1 1 8020580 4100453 3920127 0.05440 8020580 4100453 3920127 0.05440 82412 82412 0.00110 73489 73489 0.00100 4961 4961 0.00010 160862 160862 0.00220 8181442 4100453 4080989 0.05660 1 2726421 0 18836969 19050853 -213884 X 1 1 1 1 MILLE LACS HEALTH SYSTEM 200 NORTH ELM STREET ONAMIA MN 563590800 WWW.MLHEALTH.ORG 8557484 X X X X MILLE LACS HEALTH SYSTEM 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE PART V, LINE 7D X X 1 24 1 SEE PART V, LINE 7D 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X X 1 X SEE PART V, SEE LINE 16J X SEE PART V, SEE LINE 16J X SEE PART V, SEE LINE 16J X X X X X X 1 X 0 X X X X 1 X 0 0 MILLE LACS HEALTH SYSTEM PART V, SECTION B, LINE 5: MILLE LACS HEALTH SYSTEM CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING 2025 TO IDENTIFY AND PRIORITIZE THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITIES IT SERVES. INPUT WAS OBTAINED THROUGH ONE-ON-ONE INTERVIEWS WITH INDIVIDUALS REPRESENTING PUBLIC HEALTH EXPERTS, GOVERNMENT AGENCIES, MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME POPULATIONS, AND MINORITY POPULATIONS. ORGANIZATIONS PARTICIPATING IN THE ASSESSMENT PROCESS INCLUDED MILLE LACS COUNTY DEPARTMENT OF COMMUNITY & VETERANS SERVICES, MILLE LACS COUNTY COMMISSIONERS, ONAMIA POLICE DEPARTMENT, MILACA PUBLIC SCHOOLS, ONAMIA PUBLIC SCHOOLS, AND MEDICAL PROVIDERS AND DEPARTMENT LEADERS FROM MILLE LACS HEALTH SYSTEM. THESE ORGANIZATIONS WERE SELECTED BECAUSE THEIR WORK BRINGS THEM INTO REGULAR CONTACT WITH UNDERSERVED, LOW-INCOME, MINORITY, AND OTHER VULNERABLE POPULATIONS WITHIN THE SERVICE AREA. IN ADDITION TO STAKEHOLDER INTERVIEWS, MILLE LACS HEALTH SYSTEM CONSIDERED QUANTITATIVE DATA FROM NUMEROUS PUBLIC SOURCES, INCLUDING THE CENTERS FOR DISEASE CONTROL AND PREVENTION, MINNESOTA DEPARTMENT OF HEALTH, U.S. CENSUS BUREAU, POPULATION HEALTH INSTITUTE COUNTY HEALTH RANKINGS, HEALTH RESOURCES & SERVICES ADMINISTRATION, NATIONAL INSTITUTES OF HEALTH, AND LOCAL PUBLIC HEALTH RESOURCES. BASED ON THE INFORMATION GATHERED AND ANALYZED, MILLE LACS HEALTH SYSTEM IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS: MENTAL HEALTH, ACCESS TO HEALTH CARE, SUBSTANCE ABUSE, OBESITY, AND ELDER CARE. THESE NEEDS WERE PRIORITIZED BASED ON COMMUNITY INPUT, POTENTIAL IMPACT ON HEALTH OUTCOMES, AND ALIGNMENT WITH THE ORGANIZATION'S MISSION. MILLE LACS HEALTH SYSTEM PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ON OUR WEBSITE AT: HTTPS://WWW.MLHEALTH.ORG/PATIENTS-VISITORS/PATIENT-RESOURCESCHNA AND IMPLEMENTATION PLAN DIRECT LINK:HTTPS://WWW.MLHEALTH.ORG/SITES/DEFAULT/FILES/2026-02/2025%20MLHS%20CHNA%20REPORT%20AND%20IMPLEMENTATION%20STRATEGY.PDF MILLE LACS HEALTH SYSTEM PART V, SECTION B, LINE 11: THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2025, MILLE LACS HEALTH SYSTEM IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS AND PRIORITIZED THEM IN THE GIVEN ORDER:1A MENTAL HEALTH1B ACCESS TO HEALTHCARE2A SUBSTANCE ABUSE2B OBESITY2C ELDER CARECONSISTENT WITH THE REQUIREMENTS OF SECTION 501(R)(3), THE IMPLEMENTATION STRATEGY IDENTIFIES MILLE LACS HEALTH SYSTEM'S PLANNED RESPONSE TO EACH SIGNIFICANT COMMUNITY HEALTH NEED. IF MILLE LACS HEALTH SYSTEM DOES NOT PLAN TO ADDRESS A HEALTH NEED, THIS IMPLEMENTATION STRATEGY EXPLAINS WHY.MENTAL HEALTH:- PRIORITIZE HIRING AND RETAINING QUALIFIED MENTAL HEALTH PRACTITIONERS, BOTH IN-PERSON AND VIA TELEHEALTH. WE ANTICIPATE THAT THIS WILL INCREASE PATIENTS' ACCESS TO MENTAL HEALTH PROVIDERS.- EXPLORE VOLUNTEERING OPPORTUNITIES OF MLHS'S LEADERSHIP TEAM, DONATING OUR TIME AND TALENTS TO HELP SOLVE FOOD INSECURITIES. WE ANTICIPATE THAT THIS WILL REDUCE COMMUNITY MEMBERS' STRESS/ANXIETY ABOUT WHERE THEIR NEXT MEAL WILL COME FROM.ACCESS TO HEALTH CARE:- CONTINUE THE AVAILABILITY OF SAME-DAY SCHEDULING THROUGH A DEDICATED PROVIDER WHO IS AVAILABLE TO SEE SAME-DAY PATIENTS. WE ANTICIPATE THAT THIS WILL RESULT IN FASTER ACCESS TO PROVIDERS TO PROACTIVELY ADDRESS COMMUNITY HEALTH NEEDS AND WILL REDUCE THE NUMBER OF EMERGENCY ROOM VISITS.- EVALUATE EXTENDED HOURS FOR MEDICAL CLINICS BY CHANGING THE SCHEDULES OF OUR NURSES, PROVIDERS AND SUPPORT STAFF. WE ANTICIPATE THAT AN EXTENSION OF CLINIC HOURS WOULD RESULT IN INCREASED ACCESS TO PROVIDERS TO PROACTIVELY ADDRESS COMMUNITY HEALTH NEEDS AND WOULD REDUCE THE NUMBER OF EMERGENCY ROOM VISITS.- ADD NEW SPECIALTIES AND SERVICES IN THE ONAMIA AREA. THIS COULD OCCUR THROUGH DIRECTLY HIRING SPECIALISTS OR BY CONTRACTING WITH OTHER ORGANIZATIONS TO PROVIDE ADDITIONAL SPECIALTY SERVICES. WE ANTICIPATE THAT THIS WILL IMPROVE PATIENT ACCESS BY PROVIDING THEM WITH GEOGRAPHICALLY CLOSER SPECIALISTS, WHICH WOULD REDUCE THEIR TRAVEL TIME AND COSTS AND INCREASE THE FREQUENCY WITH WHICH THEY CAN CONSULT WITH A SPECIALIST.ELDER HEALTH:- CONTINUE GERI-PSYCH INPATIENT UNIT- CONTINUE SOCIAL WORKER SUPPORT SERVICES TO ACUTE CARE, EMERGENCY DEPARTMENT, LONG TERM CARE, GERI-PSYCH AND HOME CARE/HOSPICE- MEDICATION THERAPY MANAGEMENT THROUGH PHARMACY SERVICES- INR MANAGEMENT FOR MEDICATION EVALUATION AND THERAPY IN OUTPATIENTCLINICS AND PHARMACY SERVICES.- PROVIDE MANAGEMENT SERVICES FOR LOCAL ASSISTED LIVING ORGANIZATION- CURA NOW OWNS AND OPERATES THE LONG TERM CARE OPERATIONS, INCLUDINGSKILLED NURSING FACILITY, HELPING ENSURE CONTINUED ACCESS TO LONG-TERMCARE AND MEMORY CARE SERVICES FOR ELDERLY RESIDENTS IN THE COMMNITY. MLHSPARTNERED WITH CURA TO SECURE THE FUTURE OF THESE SERVICES.SUBSTANCE ABUSE:- REINVIGORATE MEDICATED ASSISTED THERAPY (MAT) PROGRAM- CONTINUE PARTNERSHIP WITH FREEDOM CENTER TREATMENT PROGRAM- CONTINUE MONTHLY PAIN COMMITTEE COLLABORATION- EXPLORE BARRIERS TO TRANSPORTATION FOR CARE AND TREATMENT- EXPLORE NARCAN DISTRIBUTION AND FENTANYL TESTING KIT OPPORTUNITIESOBESITY:- PROVIDE REGISTERED DIETICIAN SERVICES- CONTINUE TO PROVIDE GROUP WEIGHT LOSS SERVICES FOR PRE-DIABETICS- CONTINUE TO PROVIDE OUTPATIENT CDE SERVICES- FAMILY MEDICINE PROVIDERS CONTINUE TO OFFER SERVICES FOR OBESITYDIAGNOSES THROUGH A VARIETY OF METHODS- OPERATE COMMUNITY PHARMACY SERVICES WITH PHARMACIST AVAILABLE TO COUNSELPATIENTSMLHS CONTINUES TO ADDRESS ELDER HEALTH, SUBSTANCE ABUSE, AND OBESITY AS PART OF ITS ONGOING COMMUNITY HEALTH IMPROVEMENT EFFORTS. WHILE THESE AREAS WERE NOT IDENTIFIED AS PRIMARY PRIORITY FOCUS AREAS IN THE CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION STRATEGY, MLHS RECOGNIZES THEIR CONTINUED IMPORTANCE TO THE HEALTH AND WELL-BEING OF THE COMMUNITIES IT SERVES. MILLE LACS HEALTH SYSTEM PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT:HTTPS://WWW.MLHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCEFINANCIAL ASSISTANCE POLICY DIRECT LINK:HTTPS://WWW.MLHEALTH.ORG/SITES/DEFAULT/FILES/2026-01/FINANCIAL%20ASSISTANCE%20POLICY%202026.PDFFINANCIAL ASSISTANCE POLICY APPLICATION DIRECT LINK:HTTPS://WWW.MLHEALTH.ORG/SITES/DEFAULT/FILES/2020-05/FINAN%20ASSIST%20APP%202020.PDFPLAIN LANGUAGE SUMMARY DIRECT LINK:HTTPS://WWW.MLHEALTH.ORG/SITES/DEFAULT/FILES/2021-08/PL%20LANG%20SUMMARY_02-08-2021.PDF 5 1 - MLHS FAMILY CLINIC - ONAMIA 200 N ELM STREET ONAMIA MN 56359 MEDICAL CLINIC 2 - MLHS FAMILY CLINIC - ISLE 375 W ISLE STREET ISLE MN 56342 MEDICAL CLINIC 3 - MLHS FAMILY CLINIC - MILACA 1010 5TH STREET SE MILACA MN 56353 MEDICAL CLINIC 4 - MLHS FAMILY CLINIC - HILLMAN 26362 370TH AVENUE HILLMAN MN 56338 MEDICAL CLINIC 5 - MLHS FAMILY CLINIC - GARRISON 27378 STATE HIGHWAY 18 GARRISON MN 56450 MEDICAL CLINIC PART I, LINE 3C: THE FEDERAL POVERTY INCOME GUIDELINES PROVIDE THE INITIAL FRAMEWORK TO DETERMINE THE INDIVIDUAL'S ABILITY TO PAY. INDIVIDUALS WITH INCOME AND ASSETS EQUAL TO OR LESS THAN THE FEDERAL POVERTY INCOME GUIDELINES, WITH NO OTHER AVAILABLE ASSETS MUST BE EVALUATED TO SEE IF THE PATIENT FIRST QUALIFIES FOR ASSISTANCE FROM ANY FEDERAL, STATE, OR LOCAL COUNTY PROGRAMS. A REASONABLE PAYMENT SCHEDULE OVER A 1- OR 2-YEAR PERIOD WILL BE DETERMINED IN THE INTERVIEW PROCESS. THE PORTION THAT WILL BE WRITTEN OFF SHOULD THEN BE CLASSIFED AS A CHARITY DISCOUNT. INDIVIDUALS WITHIN TWO (2) TIMES THE FEDERAL POVERTY GUIDELINES MAY ALSO HAVE SOME MEDICAL INSURANCE COVERAGE. THE PATIENT DEDUCTIBLE AND NONCOVERED SERVICES MAY BE LARGE ENOUGH THAT THE INDIVIDUAL IS INCAPABLE OF PAYING OFF WITHIN A 1-2 YEAR PERIOD. THEREFORE, THIS UNPAYABLE AMOUNT BY THE PATIENT MAY BE CLASSIFED AS A CHARITY DISCOUNT. PART I, LINE 7: THE COSTS INCLUDED IN PART 1, LINES 7A AND 7B WERE DERIVED BY USING THE COST-TO-CHARGE RATIO CALCULATED USING WORKSHEET 2 AND THEN APPLIED AGAINST INTERNALLY DEVELOPED NUMBERS. THE COSTS INCLUDED IN PART 1, LINES 7E, 7F AND 7I WERE ACTUAL COSTS TRACKED BY THE HEALTH SYSTEM IN THEIR FINANCIAL PROCESS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,726,421. PART III, LINE 3: MILLE LACS HEALTH SYSTEM IS REPORTING $0 BECAUSE WE DO NOT HAVE A METHOD TO REASONABLY ESTIMATE THE PORTION OF BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DIDN'T APPLY. PART III, LINE 4: SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE AND ALLOWANCE FOR CREDIT LOSSES" PARAGRAPHS ON PAGES 8-9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR INFORMATION ABOUT OUR BAD DEBT EXPENSE CALCULATION. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS AND REVENUES WERE CALCULATED USING THE 9/30/2025 COST REPORT. THE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT AS IT REPRESENTS A FINANCIAL SACRIFICE BY MILLE LACS HEALTH SYSTEM IN SERVING THE ELDERLY MEMBERS OF OUR COMMUNITY WHO MAY OTHERWISE STRUGGLE TO AFFORD HEALTH CARE. PART III, LINE 9B: REASONABLE EFFORTS TO NOTIFY AN INDIVIDUAL ABOUT FINANCIAL ASSISTANCEAT LEAST 30 DAYS PRIOR TO TAKING ANY EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL, THE HEALTH SYSTEM WILL PROVIDE THE INDIVIDUAL WITH A WRITTEN NOTICE THAT INCLUDES THE FOLLOWING INFORMATION: - THE HEALTH SYSTEM OFFERS FINANCIAL ASSISTANCE TO ELIGIBLE INDIVIDUALS. - IDENTIFY THE EXTRAORDINARY COLLECTION ACTIONS THAT MAY BE INITIATED AGAINST THE INDIVIDUAL TO OBTAIN PAYMENT FOR THE CARE. - PROVIDE A DEADLINE AFTER WHICH SUCH EXTRAORDINARY COLLECTION ACTIONS MAY BE INITIATED.THE WRITTEN NOTICE WILL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. THE HEALTH SYSTEM WILL ALSO MAKE REASONABLE EFFORTS TO ORALLY NOTIFY THE RESPONSIBLE PARTY ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS.BEFORE ENGAGING IN AN EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL, THE PATIENT ACCOUNTS MANAGER WILL DETERMINE THAT REASONABLE EFFORTS HAVE BEEN MADE TO NOTIFY THE INDIVIDUAL ABOUT FINANCIAL ASSISTANCE.IF AN INDIVIDUAL SUBMITS A FINANCIAL ASSISTANCE APPLICATION, THE HEALTH SYSTEM WILL CEASE ALL COLLECTION EFFORTS UNTIL A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY IS MADE. IF THE HEALTH SYSTEM OR ANOTHER AUTHORIZED PARTY HAS ALREADY BEGUN AN EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL WHEN THAT INDIVIDUAL SUBMITS A COMPLETE FINANCIAL ASSISTANCE APPLICATION, THE EXTRAORDINARY COLLECTION ACTION WILL BE SUSPENDED. SUSPENDING AN ACTION MEANS THAT NO FURTHER STEPS ARE TAKEN ON THAT EXTRAORDINARY COLLECTION ACTION AND NO NEW EXTRAORDINARY COLLECTION ACTIONS ARE INITIATED. THIS SUSPENSION MAY BE LIFTED WHEN THE HEALTH SYSTEM DETERMINES THE INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NOTIFIES THE INDIVIDUAL OF THAT DECISION.IF THE HEALTH SYSTEM OR ANOTHER AUTHORIZED PARTY HAS ALREADY BEGUN AN EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL WHEN THAT INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL REASONABLY AVAILABLE MEASURES WILL BE TAKEN TO REVERSE THE EXTRAORDINARY COLLECTION ACTION. SUCH STEPS INCLUDE, BUT ARE NOT LIMITED TO, VACATING A JUDGMENT AGAINST THE INDIVIDUAL, LIFTING A LEVY OR LIEN ON THE INDIVIDUAL'S PROPERTY, AND REMOVING FROM THE INDIVIDUAL'S CREDIT REPORT ANY ADVERSE INFORMATION THAT WAS REPORTED.IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION, THE HEALTH SYSTEM WILL TAKE THE FOLLOWING STEPS TO ENCOURAGE THEM TO COMPLETE THE APPLICATION: - SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT FOR THE CARE. - PROVIDE A WRITTEN NOTICE TO THE RESPONSIBLE PARTY THAT INCLUDES THE ADDITIONAL INFORMATION AND/OR DOCUMENTATION THAT MUST BE SUBMITTED, AND THE PHYSICAL LOCATION AND PHONE NUMBER OF THE PATIENT ACCOUNTS MANAGER, WHO CAN ANSWER QUESTIONS ABOUT THE FINANCIAL ASSISTANCE POLICY AND/OR PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. - ALLOW A REASONABLE AMOUNT OF TIME FOR THE RESPONSIBLE PARTY TO SUBMIT A COMPLETE FINANCIAL ASSISTANCE APPLICATION. SUCH PERIOD OF TIME WILL BE AT LEAST 30 DAYS FROM THE DATE THE WRITTEN NOTICE IS SENT TO THE RESPONSIBLE PARTY.IF THE INDIVIDUAL FAILS TO PROVIDE THE REQUESTED INFORMATION WITHIN THE STATED TIME, THE HEALTH SYSTEM MAY RENEW THE PREVIOUSLY INITIATED EXTRAORDINARY COLLECTION ACTIONS.IF AN INDIVIDUAL HAS MADE FULL OR PARTIAL PAYMENT, AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, ANY PAYMENTS IN EXCESS OF THEIR NEWLY CALCULATED REMAINING LIABILITY WILL BE REFUNDED TO THE PATIENT WITHIN 30 DAYS OF THE FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION. IF THE REFUNDABLE AMOUNT IS LESS THAN $2.00, IT WILL NOT BE REFUNDED. PART VI, LINE 2: MILLE LACS HEALTH SYSTEM ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY THROUGH THE ORGANIZATION OF COMMUNITY MEETINGS - FEEDBACK FORUMS. THE ORGANIZERS PROVIDE CONSTANT FEEDBACK OF COMMUNITY NEEDS. THERE ARE COMMUNITY FOCUS GROUPS AND HOSPITAL STAFF ATTENDANCE AT VARIOUS CLUB MEETINGS TO PROVIDE HEALTH INFORMATION AND GUIDANCE ON HOW TO ACCESS TO THE HOSPITAL'S SERVICES. PART VI, LINE 3: ELIGIBILITY FOR ASSISTANCE INFORMATION IS ON THE BILLING STATEMENTS. THE HEALTH SYSTEM ALSO PROVIDES NEWSLETTERS AND COMMUNITY OUTREACH PROGRAMS THAT INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE. AN ASSISTANCE INFORMATION SHEET IS PROVIDED TO THE PATIENT OR REPRESENTATIVE AT THE TIME OF THE SERVICE OR AT A SCHEDULED MEETING FOR ELIGIBILITY. PART VI, LINE 4: MILLE LACS HEALTH SYSTEM IS A COMMUNITY-OWNED, NOT-FOR-PROFIT HEALTH SYSTEM LOCATED IN ONAMIA, MINNESOTA, ON THE SOUTHERN SHORE OF LAKE MILLE LACS IN CENTRAL MINNESOTA. THE ORGANIZATION SERVES A PREDOMINANTLY RURAL SERVICE AREA THAT INCLUDES THE COMMUNITIES OF ONAMIA, ISLE, WAHKON, HILLMAN, GARRISON, AND MILACA, AS WELL AS SURROUNDING PORTIONS OF MILLE LACS COUNTY AND NEIGHBORING COUNTIES. MILLE LACS HEALTH SYSTEM ALSO PROVIDES MEDICAL COVERAGE TO THE NE-LA-SHING CLINIC SERVING MEMBERS OF THE MILLE LACS BAND OF OJIBWE. MORE THAN 80% OF THE ORGANIZATION'S INPATIENT AND OUTPATIENT UTILIZATION ORIGINATES FROM ITS PRIMARY SERVICE AREA. THE REGION EXPERIENCES SIGNIFICANT SEASONAL POPULATION INCREASES DUE TO TOURISM AND RECREATIONAL ACTIVITIES CENTERED AROUND LAKE MILLE LACS.THE SERVICE AREA IS PREDOMINANTLY RURAL, WITH SMALL COMMUNITIES SPREAD THROUGHOUT THE REGION. BASED ON 2023 DEMOGRAPHIC DATA, MILLE LACS COUNTY HAS A POPULATION OF APPROXIMATELY 27,400 RESIDENTS, WITH 18.7% OF RESIDENTS AGE 65 OR OLDER, A PERCENTAGE THAT EXCEEDS THE MINNESOTA AVERAGE. THE COUNTY ALSO HAS LOWER PER CAPITA INCOME AND A HIGHER UNINSURED RATE THAN THE STATE OVERALL. IN ADDITION, THE SERVICE AREA INCLUDES A MEANINGFUL NATIVE AMERICAN POPULATION ASSOCIATED WITH THE MILLE LACS BAND OF OJIBWE.THE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS OF THE COMMUNITY INFLUENCE LOCAL HEALTH CARE NEEDS. THE AREA'S AGING POPULATION CONTRIBUTES TO INCREASED DEMAND FOR SERVICES RELATED TO CHRONIC DISEASE MANAGEMENT, BEHAVIORAL HEALTH, REHABILITATION, SENIOR CARE, AND ACCESS TO SPECIALTY PROVIDERS. THE RURAL NATURE OF THE SERVICE AREA ALSO CREATES CHALLENGES RELATED TO TRANSPORTATION, ACCESS TO CARE, PROVIDER RECRUITMENT, AND AVAILABILITY OF HEALTH CARE RESOURCES. THESE FACTORS WERE REFLECTED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIED MENTAL HEALTH, ACCESS TO HEALTH CARE, SUBSTANCE ABUSE, OBESITY, AND ELDER CARE AS SIGNIFICANT COMMUNITY HEALTH NEEDS. PART VI, LINE 5: MILLE LACS HEALTH SYSTEM PROVIDES EDUCATIONAL HEALTH FAIRS, COMMUNITY MEETINGS ON HEALTH PROBLEMS, DIAGNOSIS AND PREVENTION METHODS. PART OF OUR MISSION STATEMENT IS TO ASSIST THOSE RESIDING IN AND VISITING THE MILLE LACS AREA IN ACHIEVING AND MAINTAINING OPTIMAL HEALTH. THE HEALTH SYSTEM PROVIDES PASTORAL CARE TO PATIENTS UPON REQUEST FROM OUR AREA CHURCHES CLERGY. WE SEND OUT QUARTERLY COMMUNITY HEALTH INFORMATION NEWS LETTERS. WE PROVIDE FREE BLOOD PRESSURE TESTING PROGRAMS. PART VI, LINE 7, REPORTS FILED WITH STATES MN X X X X X X 0 0 0 0 0 0 0 0 0 WILLIAM NELSON CEO/CONSULTANT 367040 0 80038 0 3446 0 7441 0 69379 0 527344 0 0 0 JAMES YOUNG HOSPITALIST 478431 0 0 0 625 0 6050 0 6990 0 492096 0 0 0 EARLE MUNNS HOSPITALIST 361398 0 2392 0 810 0 13621 0 50932 0 429153 0 0 0 RYAN FOX PHYSICIAN 287314 0 2392 0 432 0 5345 0 36053 0 331536 0 0 0 REBECCA MUWANSE PHYSICIAN 295429 0 2392 0 432 0 0 0 29462 0 327715 0 0 0 FAHAD KHEMANI PHYSICIAN 295939 0 2392 0 486 0 10800 0 17047 0 326664 0 0 0 DR ARDEN VIRNIG DIRECTOR/PHYSICIAN 205087 0 2388 0 3424 0 8319 0 43168 0 262386 0 0 0 DR PATTI HOOK-VIRNIG VP MEDICAL AFFAIRS 198404 0 2388 0 6089 0 8055 0 42815 0 257751 0 0 0 JACKIE ULSETH CNO 192291 0 0 0 716 0 1851 0 36682 0 231540 0 0 0 BECKY FOSSAND CAO 183597 0 2103 0 2473 0 7672 0 30638 0 226483 0 0 0 ANDY KNUTSON CEO 197280 0 2209 0 356 0 10640 0 9846 0 220331 0 0 0 AMY NINHAM CFO 146739 0 0 0 0 0 6748 0 41431 0 194918 0 0 0 A CITY OF ONAMIA MN 416005437 2020-07-08 6990000 REFUND SERIES 2001 AND 2003 DEBTS AND FACILITY CONSTRUCTION 0 0 0 A 868969 6990000 72435 586691 6330874 2006 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS COMPRISED OF THE ELECTED OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS OF THE ORGANIZATION IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND IS AT ALL TIMES SUBJECT TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 DR. PATTI HOOK-VIRNIG AND DR. ARDEN VIRNIG HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 7A TWO MEMBERS OF THE BOARD OF DIRECTORS ARE PHYSICIANS OF MILLE LACS HEALTH SYSTEM. THESE DIRECTORS ARE ELECTED BY THE MEDICAL STAFF ANNUALLY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE 990 TAX FORM, IT WAS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR/OFFICER OF MLHS SHALL COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNARIE UPON APPOINTMENT AND THEREAFTER AT THE TIME OF EACH ANNUAL MEETING. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO AND COMPLIANCE OFFICER. EACH DIRECTOR/OFFICER OF MLHS SHALL FULLY DISCLOSE ANY CONFLICTS OF INTERESTS. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER/OFFICER MAY BE ASKED TO STEP DOWN. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND OTHER OFFICERS' COMPENSATION IS EVALUATED BY THE BOARD OF DIRECTORS. COMPARABILITY DATA FROM OTHER AREA FACILITIES IS USED ALONG WITH AN EXECUTIVE SALARY SURVEY TO DETERMINE COMPENSATION FOR TOP MANAGEMENT OFFICIALS. THIS PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2025. FORM 990, PART VI, SECTION C, LINE 19 THE HEALTH SYSTEM'S GOVERNING DOCUMENTS, CONFLICT OF INTERET POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 33,725. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,725. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 5,087,195. MANAGEMENT AND GENERAL EXPENSES 2,328,396. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,415,591. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,980,147. MANAGEMENT AND GENERAL EXPENSES 379,537. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,359,684. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -12,287. THOMPSON'S LAKE COUNTRY DRUG INC 200 NORTH ELM STREET PO BOX A ONAMIA MN 56359 463957632 PHARAMCEUTICAL SALES MN MILLE LACS HEALTH SYSTEM S -485485 1246344 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0