Community Benefit Insight - Tax-exempt hospital

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Mille Lacs Health System

Mille Lacs Hospital

200 North Elm St
Onamia, MN 56359

Bed count	31	Medicare provider number	241356	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 410785161

Display data for year:

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

4.84%

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	$ 0 0 %
Medicaid as % of operating expenses	$ 2,314,251 4.53 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 85,178 0.17 %
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.	$ 66,893 0.13 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 5,736 0.01 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
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	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 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	$ 1,319,549 2.58 %
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 $ 43711413 including grants of $ 0) (Revenue $ 44949281)
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.

Facility Information

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

MILLE LACS HEALTH SYSTEM
PART V, SECTION B, LINE 5: WE GATHERED QUALITATIVE INFORMATION AND PERSPECTIVES ON COMMUNITY HEALTH NEEDS THROUGH ONE-ON-ONE AND SMALL GROUP INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS. THESE INTERVIEWS WERE CONDUCTED IN JULY 2019. THE PRIMARY GOAL OF THESE INTERVIEWS WAS TO ASCERTAIN A RANGE OF PERSPECTIVES ON THE COMMUNITY'S HEALTH NEEDS. WE GATHERED INFORMATION FROM THE FOLLOWING SPECIFIED GROUPS WITHIN OUR COMMUNITY: - PEOPLE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH; - GOVERNMENT HEALTH DEPARTMENTS AND OTHER GOVERNMENT AGENCIES; - LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED POPULATIONS; - LEADERS, REPRESENTATIVES OR MEMBERS OF LOW-INCOME POPULATIONS; AND - LEADERS, REPRESENTATIVES OR MEMBERS OF MINORITY POPULATIONS.THE FOLLOWING AGENCIES, ORGANIZATIONS AND BUSINESSES PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS BY CONTRIBUTING THEIR PERSPECTIVES, OPINIONS AND OBSERVATIONS. - MILLE LACS COUNTY DEPARTMENT OF COMMUNITY & VETERAN SERVICES - MILLE LACS BAND OF THE OJIBWE TRIBE - MILLE LACS COUNTY SHERIFF'S DEPARTMENT - CITY OF ONAMIA - CITY OF ISLE - MILLE LACS HEALTH SYSTEM - HOLY CROSS CATHOLIC CHURCH - FREEDOM CENTERWE BELIEVE EACH OF THESE ORGANIZATIONS IS A QUALIFIED REPRESENTATIVE OF THE IDENTIFIED GROUPS BECAUSE THE NATURE OF THEIR WORK BRINGS THEM INTO CONTACT WITH THOSE GROUPS ON A REGULAR BASIS. FOR MANY OF THE ORGANIZATIONS LISTED, THE NATURE OF THEIR MISSION AND PURPOSE REQUIRES THEM TO CONSIDER THE SPECIAL NEEDS OF THE GROUPS IDENTIFIED.

MILLE LACS HEALTH SYSTEM
PART V, SECTION B, LINE 11: THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2019, MILLE LACS HEALTH SYSTEM IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS AND PRIORITIZED THEM IN THE GIVEN ORDER:1. TRANSPORTATION ACCESS2. SUBSTANCE ABUSE3. MENTAL HEALTHCONSISTENT WITH THE REQUIREMENTS OF SECTION 501(R)(3), THIS 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.TRANSPORTATION ACCESS: TRANSPORTATION AND ACCESS WILL ALWAYS BE A VERY DIFFICULT ISSUE TO SOLVE DUE TO OUR GEOGRAPHIC LOCATION. THE LOW POPULATION DENSITY AND THE GEOGRAPHIC DIFFICULTIES CAUSED BY LAKE MILLE LACS MEANS THAT TRANSPORTATION OPTIONS LIKE LYFT, UBER, TAXI SERVICES, OR REGULAR BUS SERVICES AREN'T ECONOMICALLY FEASIBLE IN OUR AREA.WE WILL WORK WITH THE MILLE LACS COUNTY BUS SERVICE, WHICH CURRENTLY SERVES THE COMMUNITIES OF MILACA AND PRINCETON, TO IDENTIFY AND SUPPORT ANY POTENTIAL EXPANSION INTO OUR AREA. BASED ON PAST DISCUSSIONS, WE ARE NOT HOPEFUL THAT OUR RURAL AREA CAN ECONOMICALLY SUPPORT ADDITIONAL BUS SERVICES.WE WILL CONTINUE OUR INVOLVEMENT WITH COMMUNITY GROUPS LOOKING TO CREATE ADDITIONAL OPTIONS FOR TRANSPORTATION, GROCERIES, AND OTHER ECONOMIC ADDITIONS TO OUR COMMUNITY- ESPECIALLY IN ONAMIA.SUBSTANCE ABUSE & MENTAL HEALTH:SUBSTANCE ABUSE AND MENTAL HEALTH ARE PROBLEMS THAT EXTEND BEYOND OUR COMMUNITY. THEY HAVE ALSO PROVEN TO BE STATE- AND COUNTRY-WIDE ISSUES.WE WILL CONTINUE TO SEEK LICENSED PSYCHOLOGISTS AND PSYCHIATRISTS, AS WELL AS TELE-PSYCHIATRISTS, TO PROVIDE MENTAL HEALTH SERVICES AT OUR FACILITIES. UNFORTUNATELY, WE FIND THESE SERVICES ARE EXTREMELY DIFFICULT TO LOCATE, ESPECIALLY IN OUR RURAL ENVIRONMENT.SUBSTANCE ABUSE COVERS A WIDE RANGE OF HEALTH ISSUES INCLUDING TOBACCO, ALCOHOL, AND PRESCRIPTION AND ILLICIT DRUGS. EFFECTIVE SUBSTANCE ABUSE TREATMENT HAS PROVEN VERY DIFFICULT TO PROVIDE DUE TO THE COSTS ASSOCIATED WITH EFFECTIVE TREATMENT. WE WILL CONTINUE TO PROVIDE A SUBOXONE CLINIC AT MILLE LACS HEALTH SYSTEM. WE WILL ALSO LOOK FOR WAYS TO PARTNER WITH THE FREEDOM CENTER, A FACILITY DEDICATED TO PROVIDING A COMPREHENSIVE CONTINUUM OF CARE FOR TO ALCOHOL- AND DRUG-ABUSES, WHICH OPENED IN 2018. SPECIFIC PROGRAMS AT FREEDOM CENTER INCLUDE OUTPATIENT CHEMICAL DEPENDENCY TREATMENT FOR MEN AND WOMEN AGES 13 AND UP, AND ANGER MANAGEMENT, DOMESTIC VIOLENCE, DUI/DWI, GAMBLING TREATMENT, AND PREVENTION EDUCATION CLASSES. WE ARE ALSO WORKING ON A POTENTIAL GRANT OPPORTUNITY THAT WOULD SERVE SEVERAL HOSPITALS, ALLOWING FOR THE EXPANSION OF OUR TREATMENT CAPABILITIES WITHIN OUR CLINIC IN ONAMIA.BECAUSE OF LIMITED RESOURCES, WE CANNOT RESPOND EFFECTIVELY TO EVERY IDENTIFIED HEALTH NEED. WE HAVE CHOSEN OUR RESPONSES BASED ON ANALYSES OF OUR RESOURCES, OUR MISSION, OUR EXISTING SPECIALTIES, COMMUNITY PRIORITIES, AND EXISTING COMMUNITY RESOURCES. THE COVID RESPONSE FROM MARCH 2020 AND FORWARD HAS CAUSED A DISTRACTION FROM ANY OF THE PLANNED ACTIIONS FOR THE COMMUNITY HEALTH NEEDS.

PART V, LINE 16A, FAP WEBSITE:
HTTPS://WWW.MLHEALTH.ORG/SITES/DEFAULT/FILES/2023-02/FINANCIAL%20ASSISTANCE%20POLICY.PDF

PART V, LINE 16B, FAP APPLICATION WEBSITE:
HTTPS://WWW.MLHEALTH.ORG/SITES/DEFAULT/FILES/2020-05/FINAN%20ASSIST%20APP%202020.PDF

PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:
HTTPS://WWW.MLHEALTH.ORG/SITES/DEFAULT/FILES/2021-08/PL%20LANG%20SUMMARY_02-08-2021.PDF

Supplemental Information

Schedule H (Form 990) Part VI

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 SUCH AS MA. 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 DEDUCTABLE 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 $ 1,319,549.

PART III, LINE 2:
"SEE THE ""PATIENT AND RESIDENT ACCOUNTS RECEIVABLE"" PARAGRAPHS ON PAGE 7 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR INFORMATION ABOUT OUR BAD DEBT EXPENSE CALCULATION."

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"" PARAGRAPHS ON PAGE 7 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 9/30/2022 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 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 LOCATED 80 MILES NORTH OF THE MINNEAPOLIS MN AREA IN CENTRAL MINNESOTA. THE HEALTH SYSTEM SERVES THE PREDOMINATELY RURAL AREA OF MILLE LACS COUNTRY AND PORTIONS OF MORRISON, AITKIN, CROW WING, AND KANABEC COUNTIES, PLUS THE MILLE LACS OJIBW INDIAN RESERVATION. THE MILLE LACS PRIMARY SERVICE AREA INCLUDES 15,000 TO 18,000 YEAR ROUND RESIDENTS WITH THE POPULATION DOUBLING DURING THE PEAK TOURIST SEASON. PERSONS LIVING BELOW THE POVERTY LEVEL IN MILLE LACS COUNTY IS 10.9% FROM THE US CENSUS. THE DEMOGRAPHIC AND SOCIOECONOMIC PROFILE COMMON TO OUR RURAL COMMUNITY ALSO INFLUENCES THE DEMANDS ON OUR HEALTHCARE SYSTEM. RURAL AREAS IN GENERAL HAVE GREATER CONCENTRATIONS OF ELDERLY PEOPLE THAN DO URBAN AREAS. AN OLDER POPULATION IS MORE LIKELY TO HAVE CHRONIC HEALTHCARE NEEDS, WHICH CAN PLACE A HEAVY BURDEN ON COMMUNITIES THAT ALREADY FACE SHORTAGES.

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

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 BUSINESS OFFICE 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 BUSINESS OFFICE 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 $5.00, IT WILL NOT BE REFUNDED.

Operating expenses	$ 51,072,396
Total amount spent on community benefits as % of operating expenses	$ 2,472,058 4.84 %