Community Benefit Insight - Tax-exempt hospital

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Lakewood Health System

Lakewood Health System

49725 County 83
Staples, MN 56479

Bed count	37	Medicare provider number	241329	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 411842965

Display data for year:

Community Benefit Spending- 2020
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

1.05%

Spending by Community Benefit Category- 2020
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2020

Additional data

Community Benefit Expenditures: 2020

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	$ 606,163 0.57 %
Medicaid as % of operating expenses	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 5,000 0.00 %
Subsidized health services as % of operating expenses	$ 195,973 0.18 %
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.	$ 289,405 0.27 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 26,036 0.02 %
Community building* as % of operating expenses	$ 5,191 0.00 %

* = 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	$ 5,191 0.00 %
Physical improvements and housing as % of community building expenses	$ 5,191 100 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 0 0 %
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	$ 0 0 %
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: 2020

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	$ 1,022,010 0.95 %
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: 2020

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: 2020

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 $ 76052143 including grants of $ 0) (Revenue $ 92663618)
HOSPITAL AND CLINICS -LAKEWOOD HEALTH SYSTEM (THE ORGANIZATION) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, OUTPATIENT, EMERGENCY, AND OTHER SPECIALTY HEALTH CARE SERVICES, INCLUDING A 10-BED GERIATRIC BEHAVIORAL HEALTH UNIT IN STAPLES, MINNESOTA. THE ORGANIZATION ALSO OPERATES RURAL HEALTH CLINICS LOCATED IN STAPLES, MOTLEY, PILLAGER, EAGLE BEND, AND BROWERVILLE, MINNESOTA. PHYSICIANS, PHYSICIAN'S ASSISTANTS, AND NURSE PRACTITIONERS PROVIDE CLINIC PATIENTS WITH PRIMARY CARE AND OTHER HEALTH CARE SERVICES. IN ADDITION, THE ORGANIZATION OPERATES A DERMATOLOGY CLINIC IN SARTELL, MINNESOTA.THE ORGANIZATION PROVIDED FOR 3,760 INPATIENT HOSPITAL AND SWING-BED DAYS, 2,835 INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT DAYS, 75,664 MEDICAL AND MENTAL HEALTH RURAL HEALTH CLINIC VISITS AND 8,465 DERMATOLOGY CLINIC VISITS.

4B (Expenses $ 10601268 including grants of $ 0) (Revenue $ 15401936)
SENIOR SERVICES -THE ORGANIZATION OPERATES A 100-BED, MEDICARE-CERTIFIED SKILLED NURSING FACILITY IN STAPLES, MINNESOTA, THAT PROVIDES LONG-TERM AND REHABILITATIVE CARE TO RESIDENTS. IN ADDITION TO SKILLED NURSING CARE, THE ORGANIZATION ALSO OPERATES HOME HEALTH CARE AND HOSPICE PROGRAMS TO PROVIDE NURSING CARE AND ASSISTANCE AT THE PATIENT'S RESIDENCE. ASSISTED LIVING AND INDEPENDENT LIVING FACILITIES OPERATED BY THE ORGANIZATION, LOCATED IN STAPLES, MINNESOTA, PROVIDE COMBINATIONS OF HEALTH-RELATED AND SUPPORTIVE SERVICES FOR TENANTS. THE ORGANIZATION PROVIDED FOR 29,277 RESIDENT DAYS IN THE NURSING HOME AND 750 ASSISTED LIVING UNIT RENTED MONTHS.

Facility Information

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

LAKEWOOD HEALTH SYSTEM
PART V, SECTION B, LINE 5: THE CHNA PROCESS WAS CONDUCTED DURING 2018-2019. DATA WAS COLLECTED IN CONJUNCTION WITH TRI-COUNTY HEALTH CARE, CHI ST. GABRIEL'S HEALTH, CENTRACARE HEALTH LONG PRAIRIE, TODD COUNTY PUBLIC HEALTH, WADENA COUNTY PUBLIC HEALTH AND MORRISON COUNTY PUBLIC HEALTH. COMMUNITY STAKEHOLDER INTERVIEWS AND A COMMUNITY SURVEY IDENTIFIED COMMUNITY PERCEPTION OF HEALTH NEEDS AND WHAT MAKES A HEALTHY COMMUNITY IN MORRISON, TODD AND WADENA COUNTIES. FOR THE PURPOSES OF THIS ASSESSMENT, DATA GATHERED REFLECTS THE CORE SERVICE AREA OF LHS (ZIP CODES 56479 AND 56466) AND THE THREE COUNTIES MENTIONED PREVIOUSLY.

LAKEWOOD HEALTH SYSTEM
PART V, SECTION B, LINE 6B: THE DATA COLLECTED FOR THE CHNA WAS DONE IN CONJUNCTION WITH TODD-WADENA HEALTHY CONNECTIONS, WHICH HAS MEMBERS REPRESENTING LHS, TRI-COUNTY HEALTH CARE, TODD COUNTY HEALTH & HUMAN SERVICES, AND WADENA COUNTY PUBLIC HEALTH.PART V, SECTION B, LINE 7A:HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEED

LAKEWOOD HEALTH SYSTEM
PART V, SECTION B, LINE 7D: COMMUNITY PRESENTATIONS OCCURRED AT AREA SERVICE CLUBS, TO OUR DISTRICT TOWNSHIP ANNUAL MEETINGS, AND KEY COMMUNITY STAKEHOLDER GROUPS (ROTARY, LIONS, SCHOOL DISTRICT, CITY OF STAPLES) JAN-FEB 2020. PART V, SECTION B, LINE 10:HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEED

LAKEWOOD HEALTH SYSTEM
PART V, SECTION B, LINE 11: AN INTERNAL COMMUNITY HEALTH NEEDS ASSESSMENT TASK FORCE ANALYZED AND RANKED THE INDICATORS BASED ON COMMUNITY IMPACT, POTENTIAL FOR CHANGE, ECONOMIC FEASIBILITY AND ALIGNMENT TO THE MISSION OF LHS. TAKING INTO ACCOUNT WHAT OTHER COMMUNITY RESOURCES ARE CURRENTLY AVAILABLE TO MEET NEEDS IDENTIFIED, THE FOLLOWING HEALTH NEEDS WERE DETERMINED TO BETHE TOP PRIORITY FOR LHS:1. HEALTHY BODY WEIGHT ADULT & CHILD2. MENTAL WELLBEING 3. SOCIAL DETERMINANTSEACH OF THESE HEALTH NEEDS WILL BE ADDRESSED BY THE DEVELOPMENT AND IMPLEMENTATION OF INTERVENTIONS STARTING IN EARLY 2020. ALL IMPLEMENTED STRATEGIES WILL BE MEASURED AND EVALUATED OVER THE THREE-YEAR PERIOD TO DETERMINE IF HEALTH NEEDS ARE BEING MET AND IF THE INTERVENTIONS ARE EFFECTIVELY IMPACTING THE PRIORITIES IDENTIFIED.

LAKEWOOD HEALTH SYSTEM
PART V, SECTION B, LINE 13H: THE AMOUNT INVOICED DOES NOT CHANGE, HOWEVER A DISCOUNT AMOUNT IS DETERMINED BY INCOME LEVEL AND UNINSURED STATUS THAT WILL RESULT IN THE AMOUNT OF PAYMENT, IF ANY, FROM THE FAP-ELIGIBLE PATIENT.

LAKEWOOD HEALTH SYSTEM
PART V, SECTION B, LINE 16J: EACH APPLICABLE ADMISSION AREA HAS A POLICY AVAILABLE FOR THE PATIENT AS NEEDED AND UPON REQUEST.FAP:HTTPS://LAKEWOODHEALTHSYSTEM.COM/BILL-PAY/FAP APPLICATION:HTTPS://LAKEWOODHEALTHSYSTEM.COM/BILL-PAY/FAP PLAIN LANGUAGE SUMMARY:HTTPS://LAKEWOODHEALTHSYSTEM.COM/BILL-PAY/

LAKEWOOD HEALTH SYSTEM
PART V, SECTION B, LINE 24: THERE ARE CHARGES THAT ARE EXEMPT FROM THE FAP DISCOUNTS, SO IN THIS CASE YES WE WOULD CHARGE THE AMOUNT EQUAL TO THE GROSS CHARGE. EXAMPLES WOULD BE A DOT PHYSICAL, A COPAY BALANCE THAT INSURANCE WOULD LEAVE FOR THE CLIENT AS WE CANNOT DISCOUNT COPAYS AND IN VITRO FERTILIZATION SERVICES.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 7G:
AMOUNTS USED FOR SUBSIDIZED SERVICES WERE CALCULATED USING DETAILED REPORT DATA KEPT BY THE ORGANIZATION. DATA INCLUDED THE TOTAL CHARGES, LESS ALLOWANCES AND DISCOUNTS, MEDICAID; AND ACTUAL COST OF SERVICES PROVIDED. SUBSIDIZED SERVICES INCLUDED TRANSPORTATION SERVICES FOR 2020. THERE ARE NO PHYSICIAN CLINICS.

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 $ 1,762,082.

PART II, COMMUNITY BUILDING ACTIVITIES:
"LAKEWOOD HEALTH SYSTEM HAS SET ASIDE A SMALL AREA OF LAND ON WHICH A COMMUNITY PARK WAS ESTABLISHED. TO PROMOTE PHYSICAL ACTIVITY IN CHILDREN, LHS PURCHASED PLAYGROUND EQUIPMENT FOR THE PARK. THIS PARK IS THE ONE MOST OFTEN UTILIZED BY CHILDREN AND IS AFFECTIONATELY KNOWN AS THE ""DINO PARK"" DUE TO SOME OF THE EQUIPMENT HAVING A DINOSAUR THEME."

PART III, LINE 2:
THE AMOUNT IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES FOR SERVICES WRITTEN OFF AS BAD DEBT BY THE COST-TO-CHARGE RATIO.

PART III, LINE 3:
THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY IS NOT REASONABLE TO CALCULATE FOR THE ORGANIZATION. LAKEWOOD DOES NOT DO PRESUMPTIVE CHARITY CARE OR PARO (PAYMENT ASSISTANCE RANK ORDER) SCORING SO THERE IS NO ESTIMATE ELECTED.LAKEWOOD DOES HAVE A FINANCIAL ASSISTANCE POLICY THAT PROVIDES DISCOUNTED OR FREE CARE. LAKEWOOD IS ALSO COMMITTED TO PROVIDING OTHER COMMUNITY BENEFIT AND COMMUNITY BUILDING FUNCTIONS. THE OPPORTUNITY TO PROVIDE MORE DISCOUNTED OR FREE CARE OR PERFORM ADDITIONAL COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES IS LIMITED AS BAD DEBT COSTS INCREASE.

PART III, LINE 4:
MANAGEMENT PROVIDES FOR POTENTIALLY UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO VALUATION ALLOWANCE AND A CREDIT TO PATIENTS ACCOUNTS RECEIVABLE.

PART III, LINE 8:
THE MEDICARE ALLOWABLE COST OF CARE RELATING TO PAYMENTS ON LINE 5 WERE CALCULATED USING INFORMATION PREPARED FROM OUR FILED 2020 MEDICARE COST REPORT.A LARGE PERCENTAGE OF LAKEWOOD PATIENTS ARE MEDICARE ELIGIBLE AND LAKEWOOD WILL CONTINUE TO PROVIDE SERVICES DESPITE ANY SHORTFALL.

PART III, LINE 9B:
PATIENTS ARE REQUIRED TO APPLY FOR MEDICAL ASSISTANCE IN ORDER TO RECEIVE A 50% OR GREATER DISCOUNT PER LAKEWOOD'S CUSTOMER ASSISTANCE PROGRAM.

PART VI, LINE 2:
THE ORGANIZATION CONDUCTS COMMUNITY SURVEYS AND USES PATIENT FEEDBACK TO ASSESS THE NEEDS OF THE COMMUNITIES IT SERVES.

PART VI, LINE 3:
PATIENT FINANCIAL SERVICES (PFS) STAFF ARE AVAILABLE AND UTILIZED THROUGHOUT THE PATIENT EXPERIENCE. PFS STAFF EDUCATE PATIENTS ON MEANS-TESTED PROGRAMS AVAILABLE TO THE PATIENT AS WELL AS ASSIST THE PATIENT WITH THE CUSTOMER ASSISTANCE APPLICATION PROCESS. PAYMENT PLANS ARE ALSO ESTABLISHED TO ASSIST PATIENTS IN PAYING OFF OBLIGATIONS OWED TO THE ORGANIZATION.

PART VI, LINE 4:
"LAKEWOOD HEALTH SYSTEM OFFERS A BROAD SPECTRUM OF CARE. OUR SYSTEM INCLUDES A STATE-OF-THE-ART MAIN CAMPUS WITH A 25-BED, CRITICAL ACCESS HOSPITAL AND CLINIC (STAPLES, MN); FOUR MODERN SATELLITE CLINICS (BROWERVILLE, PILLAGER, MOTLEY & EAGLE BEND, MN), SENIOR SERVICES CARE AND HOUSING, A SPECIALIZED SENIOR BEHAVIORAL HEALTH UNIT (STAPLES, MN), AND A DERMATOLOGY CLINIC (SARTELL, MN). WE ALSO HAVE ON-STAFF MEDICAL SPECIALISTS AND VISITING MEDICAL PARTNERS, WHICH ALLOWS US TO OFFER COMPREHENSIVE CARE IN THESE VARIOUS COMMUNITIES. ITS NEIGHBOR, MOTLEY, IS JUST A FEW MILES AWAY AND HAS ANOTHER 1,000 PEOPLE. THE TWO TOWNS COLLABORATE ON MANY COMMUNITY-WIDE INITIATIVES, INCLUDING THE LOCAL SCHOOL SYSTEM. STAPLES BOASTS MANY ATTRACTIVE STORE FRONTS AND BUSINESSES IN THE DOWNTOWN AREA, GIVING IT A ""MAIN STREET USA"" FEEL. STAPLES IS PROUD OF ITS RICH HISTORY AND ACCOMPLISHMENTS IN THE AREAS OF BUSINESS, EDUCATION, HEALTH CARE, ATHLETICS AND CULTURAL ACTIVITIES. COMMUNITY INVOLVEMENT, PASSION, AND LOYALTY IS ALIVE AND WELL IN STAPLES - FROM THE TOWN RALLYING AROUND LOCAL SPORTS TEAMS, TO ATTENDING CONCERTS AND OTHER FINE ARTS - RELATED EVENTS, TO SUPPORTING LOCAL PHILANTHROPIC EFFORTS, TO CULTURAL ACTIVITIES REPRESENTING THE STRONG SCANDINAVIAN & FINNISH ANCESTRIES IN THE AREA."

PART VI, LINE 5:
A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE WITHIN LAKEWOOD'S PRIMARY SERVICE AREA.LHS PROVIDES SPECIAL SERVICES INCLUDING PALLIATIVE CARE, MEDICAL HOME, AND HOME HEALTH, FOR THE COMMUNITY. LHS'S EMERGENCY ROOM IS AVAILABLE TO ALL DESPITE PATIENT FINANCIAL IMPLICATIONS. THERE ARE NO LIMITS IN REGARD TO THE AMOUNT OF CHARITY CARE OR CAP PROGRAM PARTICIPANTS. GOVERNMENT HEALTH SPONSORED PROGRAMS WOULD INCLUDE MEDICARE AND MEDICAID. LHS IS THE SOLE COMMUNITY PROVIDER IN THE STAPLES AREA.

PART VI, LINE 6:
N/A

Operating expenses	$ 107,160,064
Total amount spent on community benefits as % of operating expenses	$ 1,122,577 1.05 %