Community Benefit Insight - Tax-exempt hospital

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Lake View Memorial Hospital Inc

Lake View Memorial Hospital

11th Avenue & 4th Street
Two Harbors, MN 55616

Bed count	25	Medicare provider number	241308	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 410786046

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

4.28%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 372,526 1.87 %
Medicaid as % of operating expenses	$ 258,715 1.30 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 178,102 0.89 %
Subsidized health services as % of operating expenses	$ 0 0 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 45,901 0.23 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 13,770 0.07 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 13,770 0.07 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 2,066 15.00 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 11,704 85.00 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 481,734 2.41 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 17614212 including grants of $ 3000) (Revenue $ 23509677)
LAKE VIEW MEMORIAL HOSPITAL, INC. (LAKE VIEW) OPERATES A HOSPITAL AND RELATED PROGRAMS INCLUDING AMBULTAORY SURGERY, EMERGENCY ROOM AND URGENT CARE, REHABILITATION, IMAGING AND LABORATORY SERVICES IN TWO HARBORS, MN. ADDITIONALLY, LAKE VIEW OPERATES PHYSICAIN CLINICS IN TWO HARBORS, MN AND SILVER BAY, MN FOR THE BENEFIT OF LAKE COUNTY AND THE SURROUNDING COMMUNITIES. IN FURTHERANCE OF ITS CHARITABLE PURPOSE, LAKE VIEW PROVIDES A VARIETY OF BENEFITS TO THE COMMUNITY, INCLUDING OFFERING VARIOUS COMMUNITY-BASED SERVICE PROGRAMS AND DONATING SPACE FOR USE BY COMMUNITY GROUPS. ADDITIONALLY, A NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY TO IMPROVE INDIVIDUALS' STANDARD OF HEALTH. THE HOSPITAL ALSO PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED RATES TO RESIDENTS OF THE COMMUNITY, PRIMARILY THE UNINSURED AND PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT ARE UNABLE DUE TO SOCIO-ECONOMIC FACTORS.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

LAKE VIEW MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN FOUR STAGES: ASSESSMENT, PRIORITIZATION, DESIGN & FINALIZATION. THROUGH EACH PHASE OF THE ASSESSMENT PROCESS, A COLLABORATIVE COMMUNITY ASSESSMENT TEAM WAS ASKED TO REVIEW THE DATA, PRIORITIZATION & RESULTS OF COMMUNITY FOCUS GROUPS TO MAXIMIZE THE RELEVANCE OF THE ASSESSMENT. THIS GROUP INCLUDED REPRESENTATION FROM LAKE VIEW, ST. LUKE'S, LAKE COUNTY PUBLIC HEALTH & HUMAN SERVICES, THE CARLTON-COOK-LAKE-ST. LOUIS COMMUNITY HEALTH BOARD, LAKE SUPERIOR SCHOOL DISTRICT AND NON-PROFIT ORGANIZATIONS THAT WORK WITH UNDERSERVED COMMUNITIES IN LAKE COUNTY OR IN THE AREA SERVED BY LAKE VIEW HOSPITAL.

LAKE VIEW MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6A: ST LUKE'S HOSPITAL OF DULUTH

LAKE VIEW MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: LAKE COUNTY PUBLIC HEALTH, LAKE SUPERIOR SCHOOL DISTRICT, THE CARLTON-COOK-LAKE-ST. LOUIS COMMUNITY HEALTH BOARD, OTHER LOCAL NON-PROFIT ORGANIZATIONS

LAKE VIEW MEMORIAL HOSPITAL
PART V, SECTION B, LINE 7D: THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT WWW.SLHDULUTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/.

LAKE VIEW MEMORIAL HOSPITAL
"PART V, SECTION B, LINE 11: THE NEEDS CHOSEN (MENTAL HEALTH, ALCHOL/TOBACCO/DRUGS AND HEALTY LIFESTYLES) ARE DIRECTLY RELATED TO THE HEALTH NEEDS IDENTIFIED BELOW. THE POPULATIONS FOR THE CHOSEN HEALTH NEEDS OVERLAP TO A LARGE DEGREE WITH THOSE OF THE NON-SELECTED HEALTH NEEDS: 1. MENTAL HEALTH ISSUES IN YOUTH AND ADULTS 2. ALCOHOL/TOBACCO/DRUGS; SPECIFICALLY VAPING IN ADOLESCENTS AND YOUNG ADULTS3. ALCOHOL/TOBACCO/DRUGS; SPECIFICALLY OPIOD USE IN ADULTS4. HEALTHY LIFESTYLES; SPECIFICALLY FOOD ACCESS/INSECURITY5. HEALTHY LIFESTYLES; SPECIFICALLY PHYSICAL ACTIVITY THE SYSTEM BELIEVES IT HAS THE BEST OPPORTUNITY TO POSITIVELY IMPACT A LARGER PORTION OF THE POPULATION WITH THE NEEDS SELECTED. PROGRESS TO DATE ON THE 2019/2020 COMMUNITY HEALTH NEEDS ASSESSMENT ARE AS FOLLOWS:PRIORITY 1: MENTAL HEALTH - LAKE VIEW HIRED A BEHAVIORAL HEALTH NURSE PRACTIONER TO PRACTICE IN ITS ON-CAMPUS PRIMARY CARE CLINIC. THIS PROVIDER OFFERS MENTAL HEALTH FIRST AID TRAINING TO STAFF AND COMMUNITY MEMBERS, HOSTS WELLNESS FAIRS AND WORKS CLOSELY WITH PRIMARY CARE PROVIDERS TO SUPPORT PATIENT CARE AND IDENTIFY PATIENTS WHO COULD SPECIFICALLY BENEFIT FROM BEHAVIORAL HEALTH SERVICES. ADDITIONALLY, THROUGH A PARTNERSHIP WITH THE HUMAN DEVELOPMENT CENTER, THE COMMUNITY HAS ACCESS TO COUNSELING/THERAPY SERVICES, PSYCHIATRY, MOBILE CRISIS RESPONSE AND EDUCATIONAL EVENTS. PRIORITY 2: VAPING ONE OF LAKE VIEW'S PRIMARY CARE NURSE PRACTIONERS BECAME CERTIFIED IN TOBACCO CESSATION, WHICH INCLUDES VAPING, AND WAS FEATURED BY LOCAL HIGH SCHOOLS IN EDUCATIOAL SEMINARS IN ADDITION TO CREATING EDUCATIONAL/SOCIAL MEDIA MATERIAL ADDRESSING THE VAPING ISSUES PREVALENT IN ADOLESCENTS IN THE COMMUNITY.PRIORITY 3: OPIOD USE LAKE VIEW DEVELOPED AND IMPLEMENTED STANDARDIZED TOOLS FOR OPIOD ASSESSMENT, INTERVENTION AND DOCUMENTATION IN THE OUTPATIENT SETTING. ADDITIONALLY, LAKE VIEW MODIFIED ITS PRESCRIBING PRACTICES TO PROMOTE/ENHANCE THE USE OF NON-PHARMACOLOGICA THERAPIES FOR PAIN MANAGEMENT. FURTHERMORE, THROUGH COMMUNITY EDUCATION AND PARTNERSHIPS WITH LOCAL LAW ENFORCEMENT LAKE VIEW STRIVES TO REDUCE OPIOD USAGE/ABUSE IN THE COMMUNITY.PRIORITY 4: FOOD ACCESS/INSECURITY LAKE VIEW CONTRACTS WITH LOCAL AEOA TO PROVIDE HEALTHY MEALS FOR SENIORS VIA ""MEALS ON WHEELS AND ""CONGREGATE DINING"" PROGRAMS. LAKE VIEW ALSO PARTNERS WITH LAKE COUNTY WIC TO PROVIDE DIETITIAN SERVICES INCLUDING NUTRITION EDUCATION. FURTHER GOALS FOR LAKE VIEW INCLUDE AN ON-CAMPUS RENOVATION OF THE KITCHEN, CAFETERIA AND DINING SPACES TO PROVIDE MORE HEALTHY OPTIONS, AS WELL AS CREATING COMMUNITY GARDEN SPACE NOT ONLY FOR AN OPPORTUNITY FOR COMMUNITY OUTDOOR ACTIVITY AND STRESS REDUCTION, BUT TO PROMOTE PRODUCE INTAKE AND ADDRESS FOOD INSECURITY. LAKE VIEW NUTRITION SERVICES STAFF ALSO PREPARE AND PROVIDE HEALTHY SNACKS FOR YOUTH EVENTS THROUGHOUT THE YEAR. PRIORITY 5: PHYSICAL ACTIVITY - LAKE VIEW'S FITNESS CENTER OFFERS WAIVERS FOR LOW INCOME INDIVIDUALS AS WELL AS FREE FITNESS CENTER MEMBERSHIPS AS DOOR PRIZES AND SILENT AUCTION ITEMS TO VARIOUS COMMUNITY FUNDRAISERS AND COMMUNITY EVENTS. DIETARY AND REHAB STAFF ARE ALSO FEATURED PRESENTORS WITH THE LOCAL AGING MASTERY PROGRAM. LAKE VIEW'S PHYSICAL THERAPY & FITNESS CENTER LOCATION IN THE WILLIAM KELLEY HIGH SCHOOL IN SILVER BAY CONTINUTES TO PROVIDE ACCESS TO A VARIETY OF HIGH-QUALITY EXERCISE EQUIPMENT TO THE COMMUNITY, SCHOOL STUDENTS, ATHLETES, STAFF AND COACHING PERSONNEL. THE STAFFING AND SUPERVISION OF THE FITNESS CENTER IS COVERED BY LAKE VIEW DURING FITNESS CENTER HOURS. LAKE VIEW OFFERS ONE-TIME CONSULTATIONS FREE OF CHARGE WITH A PHYSICAL THERAPIST OR EXERCISE PHYSIOLOGIST TO SET UP INDEPENDENT EXERCISE PROGRAMS IN THE FITNESS CENTER. THIS PROGRAM IS TAILORED TO ENSURE THAT INDIVIDUALS ARE PERFORMING SAFE AND APPROPRIATE EXERCISE REGIMENS TO INCREASE PHYSICAL ACTIVITY AND PREVENT OBESITY. THE FOCUS OF THE CONSULTATION IS TO INDIVIDUALIZE A FITNESS PROGRAM TO HELP CLIENTS REACH THEIR PERSONAL GOALS INCLUDING IMPROVED FITNESS AND/OR WEIGHT LOSS. LAKE VIEW REHAB ALSO PROVIDES A FREE WEIGHT LIFTING AND CONDITIONING CLASS TO HIGH SCHOOL STUDENTS THAT PROMOTES STUDENT HEALTH AND WELLNESS. A PHYSICAL THERAPIST PROVIDES THIS HOUR LONG WEIGHT CLASS TWICE A WEEK. LAKE VIEW SUPPORTS LOCAL 5K/10K WALK-RUN EVENS AND HOSTS A VARIETY OF PHYSICAL ACTIVITY CLASSES ON-CAMPUS, INCLUDING A STRENGTH AND FLEXIBILITY CLASS LED BY TRAINED COMMUNITY VOLUNTEERS AND A YOGA CLASS LED BY A PHYSICAL THERAPIST. THIS IS AN ONGOING CLASS SCHEDULE THAT HAS BEEN OFFERED FOR THE PAST 6+ YEARS. FUTURE PLANS TO IMPROVE COMMUNITY PHYSICAL ACTIVITY INCLUDE PARTNERSHIPS WITH LOCAL BIKE TRAIL INITIATIVES, CONSIDERATION OF 24 HOUR ACCESS TO FITNESS CENTER FOR EMPLOYEES, COLLABORATION WITH NEARBY STATE PARKS WELLNESS EVENTS, INCREASED OPTIONS FOR FITNESS CLASSES ON-CAMPUS AND THROUGH COMMUNITY EDUCATION AND IMPROVED ONLINE PRESENCE TO PUBLICIZE ALL HOSPITAL-SPONSORED HEALTH AND WELLNESS EVENTS AND CLASSES."

LAKE VIEW MEMORIAL HOSPITAL
PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE ONLINE AT WWW.SLHDULUTH.COM/PATIENTS-VISITORS/FINANCIAL-SERVICES/LAKE-VIEW- FINANCIAL-ASSISTANCE-PROGRAM/.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
"A FINANCIAL ASSISTANCE DETERMINATION WILL BE MADE AS SOON AS POSSIBLE AFTER A COMPLETE ""COMMON FINANCIAL CARE APPLICATION FORM"" HAS BEEN SUBMITTED. THE APPLICATION WILL BE UTILIZED TO EVALUATE A PATIENT'S FINANCIAL RESOURCES AND OBLIGATIONS AND REQUIRES THAT THE PATIENT PROVIDE COPIES OF DOCUMENTS SUPPORTING THE FOLLOWING INFORMATION: EARNED INCOME INCLUDING MONTHLY GROSS WAGES, SALARY, AND SELF-EMPLOYMENT INCOME; UNEARNED INCOME INCLUDING DIVIDENDS, INTEREST AND INCOME FROM ANY OTHER SOURCE SUCH AS UNEMPLOYMENT OR WORKERS COMPENSATION; NUMBER OF DEPENDENTS IN THE HOUSEHOLD; INFORMATION TO DETERMINE THE PATIENT'S FINANCIAL STATUS, INCLUDING ASSETS AND LIABILITIES. A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON THE VALUE OF THEIR INCOME AND ASSETS COMPUTED ON THE ""INCOME/ASSET VALUE CALCULATION WORKSHEET"" AS COMPARED TO A MULTIPLE OF THE CURRENT ""FEDERAL POVERTY GUIDELINE"". THE ASSISTANCE PROGRAM QUALIFICATIONS ARE BASED ON A SLIDING SCALE: A 100% DISCOUNT IF HOUSEHOLD INCOME IS LESS THAN 100% OF THE FEDERAL POVERTY GUIDELINES (FPG), A 90% DISCOUNT IF HOUSEHOLD INCOME IS BETWEEN 101% AND 150% OF FPG, A 75% DISCOUNT IF HOUSEHOLD INCOME IS BETWEEN 151% AND 200% OF FPG, A GREATER OF AMOUNTS GENERALLY BILLED OR 50% DISCOUNT IF HOUSEHOLD INCOME IS BETWEEN 201% AND 300% OF FPG. THE VALUE OF ASSETS IS AT OR BELOW $10,000 FOR A SINGLE PERSON AND $20,000 FOR A HOUSEHOLD OF TWO OR MORE."

PART I, LINE 7:
THE AMOUNTS IN PART I, LINE 7 WERE CALCULATED USING THE COST-TO-CHARGE RATIO PER WORKSHEET 2 OF THE IRS SCHEDULE H INSTRUCTIONS.

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 $ 481,734.

PART II, COMMUNITY BUILDING ACTIVITIES:
VIEW AND INCREASES LAKE VIEW'S AWARENESS OF COMMUNITY NEEDS. AS IT PERTAINS TO THE GENERAL HEALTH OF OUR COMMUNITIES SERVED THROUGH PARTICIPATION ON VARIOUS VOLUNTEER BOARDS AND INTERACTIONS WITH PUBLIC HEALTH AGENCIES, LAKE VIEW CAN PARTICIPATE IN SHAPING THE ECONOMIC GROWTH OF THE AREA AND COMMUNITIES SERVED. DEVELOPING AWARENESS AND STRONG STRATEGIC ALLIANCES IS VITAL TO THE SUCCESS NOT ONLY OF LAKE VIEW BUT OTHER BUSINESSES IN OUR SERVICE AREAS AS WELL. LAKE VIEW HOSPITAL CONTINUED TO COLLABORATE WITH VARIOUS COMMUNITY STAKEHOLDERS TO ADDRESS THE ONGOING, COMPLEX CHALLENGES OF PROVIDING CARE TO THE INCREASING NUMBER OF PATIENTS WITH MENTAL HEALTH ISSUES PRESENTING TO THE HOSPITAL EMERGENCY DEPARTMENT AND CLINIC. CITY AND COUNTY LAW ENFORCEMENT, EMS, COUNTY HUMAN SERVICES, COUNTY SOCIAL SERVICES, AND LOCAL GROUP HOME REPRESENTATIVES PARTICIPATED IN PROBLEM-SOLVING MEETINGS THAT CONTINUED THROUGHOUT THE YEAR. THE REHAB DEPARTMENT WAS INVOLVED IN THE COMMUNITY THROUGH OUTREACH PROGRAMS. THEY PARTICIPATED IN VARIOUS HEALTH FAIRS FOR LAKE COUNTY STAFF AND THE ANNUAL COMMUNITY PARTNERS SPRING CONFERENCE. THE STAFF PARTICIPATED IN VARIOUS EDUCATIONAL OUTREACH PROGRAMS AND ALSO HAD STUDENT INTERNS IN PT AND OT FROM LOCAL COLLEGES WITH REHAB STAFF PROVIDING ONE-ON-ONE MENTORING OF CLINICAL PATIENT SKILLS. ADDITIONALLY, A PHYSICAL THERAPIST TAUGHT STRENGTH & CONDITIONING CLASSES AT THE LOCAL HIGH SCHOOL TO INCREASE INTEREST IN PHYSICAL ACTIVITY AND PROMOTE HEALTH AND WELLNESS TO HIGH SCHOOL STUDENTS. LAKE VIEW WAS ALSO EXCITED TO CREATE A NEW POSITION OF EMPLOYEE AND COMMUNITY WELLNESS COORDINATOR, WHO FACILITATED COMMUNITY HEALTH EDUCATION EVENTS AND IS SUPPORTING THE CREATION OF A MORE COMPREHENSIVE EMPLOYEE WELLNESS PROGRAM.

PART III, LINE 2:
THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS.

PART III, LINE 3:
LAKE VIEW HOSPITAL DOES NOT HAVE A METHOD TO CALCULATE WITH REASONABLY ACCURACY THE PORTION OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DID NOT COMPLETE AN APPLICATION.

PART III, LINE 4:
"SEE THE ""PATIENT RECEIVABLES"" PARAGRAPH IN NOTE 1 ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS."

PART III, LINE 8:
THE COST-TO-CHARGE RATIO WAS THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED ON THE MEDICARE COST REPORT.THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE PEOPLE WHO RELY ON MEDICARE TEND TO BE LOWER INCOME AND MAY STRUGGLE TO ACCESS MEDICAL CARE IF THEY DIDN'T HAVE MEDICARE. LAKE VIEW HOSPITAL PROVIDES HEALTH CARE TO THESE INDIVIDUALS DESPITE THE LOSSES INCURRED THROUGH THE MEDICARE PROGRAM.

PART VI, LINE 2:
IN ACCORDANCE WITH THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, LAKE VIEW MEMORIAL HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING 2019 TO ASSESS THE NEEDS OF THE COMMUNITY. THIS REPORT WILL COVER YEARS 2020 THROUGH 2022.

PART VI, LINE 3:
A REASONABLE EFFORT IS MADE TO ENSURE PATIENTS ARE AWARE OF ALL FINANCIAL ASSISTANCE OPPORTUNITIES, INCLUDING CITY, COUNTY, STATE, FEDERAL AND OTHER PRIVATE PROGRAMS. THE NOTICE OF FINANCIAL AID IS POSTED IN ALL MAJOR PATIENT REGISTRATION AREAS OF THE HOSPITAL AS WELL AS ON THE HOSPITAL'S WEBSITE. IN ADDITION, THE NOTICE IS AVAILABLE TO PATIENTS IN PRINTED FORM. TRAINING AND INFORMATION REGARDING FINANCIAL ASSISTANCE IS PROVIDED TO ALL MEMBERS OF THE STAFF THAT INTERACT WITH PATIENTS. AT A MINIMUM, THESE INDIVIDUALS ARE PREPARED TO REFER THE PATIENT TO HOSPITAL BUSINESS OFFICE STAFF OR SOCIAL WORKERS.

PART VI, LINE 6:
LAKE VIEW MEMORIAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

PART VI, LINE 7, REPORTS FILED WITH STATES
MN

PART III, LINE 9B:
PRESUMPTIVE FINANCIAL ASSISTANCE ELIGIBILITY - THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR FINANCIAL DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE OR A LACK OF SUPPORTING DOCUMENTATION. IN THE EVENT THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE, LAKE VIEW MAY USE OUTSIDE AGENCIES OR VENDORS IN DETERMINING ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. THESE RESOURCES MAY USE DEMOGRAPHIC AND HOUSEHOLD INFORMATION AND/OR CREDIT SCORING TECHNOLOGY TO DETERMINE THE PERCENT OF ASSISTANCE TO APPLY TO THE PATIENT'S ACCOUNT. PATIENTS WHO MEET PRESUMPTIVE ELIGIBILITY CRITERIA MAY BE GRANTED FINANCIAL ASSISTANCE WITHOUT COMPLETING THE APPLICATION. IF A PATIENT QUALIFIES FOR PRESUMPTIVE CHARITY AFTER ALL BILLING SERVICE COLLECTION EFFORTS HAVE FAILED, LAKE VIEW APPLIES THE PERCENTAGE OF FINANCIAL ASSISTANCE AND SENDS THE REMAINING BALANCE TO THE COLLECTION AGENCY. IF A PATIENT QUALIFIES FOR PRESUMPTIVE CHARITY BEFORE ALL COLLECTION EFFORTS HAVE FAILED, LAKE VIEW APPLIES THE PERCENTAGE OF FINANCIAL ASSISTANCE AND NOTIFIES THE BILLING SERVICE OF THE REDUCTION. THE BILLING SERVICE CONTINUES COLLECTION ACTIVITY ON THE ADJUSTED BALANCE.

PART VI, LINE 4:
LAKE VIEW MEMORIAL HOSPITAL IS LOCATED IN THE CITY OF TWO HARBORS, LAKE COUNTY, MN, A RURAL COMMUNITY 25 MILES NORTHEAST OF DULUTH, MN, ON THE SHORES OF LAKE SUPERIOR. LAKE VIEW IS THE SOLE HEALTH CARE PROVIDER IN LAKE COUNTY, SERVING A POPULATION OF APPROXIMATELY 3,500 IN THE CITY OF TWO HARBORS, 1,600 IN THE CITY OF SILVER BAY, AND 10,500 TOTAL PEOPLE IN THE COMBINED PRIMARY AND SECONDARY SERVICE AREAS . THE MARKET AREA IS PROJECTED TO GROW BY APPROXIMATELY 2.0% FROM 2020 TO 2030. THE PRIMARY SERVICE AREA INCLUDES NINE COMMUNITIES: BEAVER BAY, BRIMSON, FINLAND, ISABELLA, KNIFE RIVER, SCHROEDER, SILVER BAY, TOFTE AND TWO HARBORS. THESE COMMUNITIES SUPPLY APPROXIMATELY 90% OF THE HOSPITAL'S INPATIENT AND SWING BED DISCHARGES. THE SECONDARY SERVICES AREA CONTAINS SIX COMMUNITIES, DEFINED BY ZIP CODE, FROM THE DULUTH AREA, AND ACCOUNT FOR 6% OF THE HOSPITAL'S INPATIENT AND SWING BED DISCHARGES. THE REMAINING 4% OF DISCHARGES COMES FROM COMMUNITIES OUTSIDE THESE SERVICE AREAS, LARGELY ATTRIBUTABLE TO TOURISM IN THE AREA. THE TWO HARBORS AREA OFFERS A WIDE ARRAY OF ACTIVITIES/ATTRACTIONS FOR TOURISTS AND RESIDENTS INCLUDING HIKING, FESTIVALS, CROSS-COUNTRY SKING, SNOWMOBILING, BIKING, CAMPING, FISHING, GOLF, BAND CONCERTS, BOATING, AND THE LAKE COUNTY FAIR.

PART VI, LINE 5:
LAKE VIEW MEMORIAL HOSPITAL IS THE ONLY HOSPITAL LOCATED IN LAKE COUNTY, MN. LAKE VIEW HAS A SIGNIFICANT IMPACT ON THE OVERALL HEALTH AND ACCESS TO MEDICAL SERVICES THROUGHOUT LAKE COUNTY BY PROVIDING A VARIETY OF HEALTH CARE SERVICES IN TWO HARBORS, SILVER BAY AND SURROUNDING AREAS. RESIDENTS CAN RECEIVE HIGH-QUALITY CARE IN THEIR OWN COMMUNITY WITHOUT HAVING TO DRIVE LONG DISTANCES TO LARGER CITIES. LAKE VIEW OFFERS COMPREHENSIVE SERVICES IN ITS MEDICAL CLINICS WITH PRIMARY AND SPECIALTY PHYSICIANS, RETAIL PHARMACY, HOME HEALTH SERVICES IN PARTNERSHIP WITH ST. LUKE'S HOSPITAL, COMPREHENSIVE REHAB SERVICES AND FITNESS CENTERS (PT, OT, SPEECH-LANGUAGE PATHOLOGY, CARDIAC REHAB), DIAGNOSTIC RADIOLOGY, SURGICAL AND PROCEDURAL SERVICES, FULL-SERVICE MEDICAL LAB, EMERGENCY ROOM AND URGENT CARE, AND A VARIETY OF INPATIENT SERVICES (OBSERVATION, ACUTE, SUB-ACUTE AND RESPITE PATIENTS). THE HOSPITAL PLAYS A VITAL ROLE IN THE INFRASTRUCTURE OF THE COUNTY AND IS ONE OF THE LARGEST EMPLOYERS IN TWO HARBORS WITH 136 EMPLOYEES. LAKE VIEW ALSO EMPLOYS MANY INDIVIDUALS WITH MODERATE TO HIGH INCOMES. LAKE VIEW IS A SIGNIFICANT PURCHASER OF GOODS AND SERVICES IN LAKE COUNTY, AND THIS RESULTS IN A POSITIVE IMPACT ON THE LOCAL ECONOMY. LAKE VIEW SUPPORTS MANY COMMUNITY ORGANIZATIONS THAT IMPACT THE OVERALL HEALTH OF THE COMMUNITY, INCLUDING BUT NOT LIMITED TO COMMUNITY PARTNERS, LAKE SUPERIOR SCHOOL DISTRICT, LAKE COUNTY AMBULANCE SERVICE, AND GOVERNMENTAL AGENCIES. ACCESS TO HIGH-QUALITY HEALTH CARE FACILITIES AND SCHOOLS IS VERY IMPORTANT IN ATTRACTING NEW BUSINESSES, RESIDENTS, AND FAMILIES TO COMMUNITIES. LAKE VIEW OFFERS THIS ACCESS TO COMPREHENSIVE FACILITIES AND PROVIDERS, AS WELL AS PROVIDING EMPLOYMENT OPPORTUNITIES TO NEW RESIDENTS.

Operating expenses	$ 19,970,260
Total amount spent on community benefits as % of operating expenses	$ 855,244 4.28 %