4A (Expenses $ 9791332 including grants of $ 14762) (Revenue $ 11004208)
MADISON HOSPITAL IS A 12-BED HOSPITAL, WHICH PROVIDES SERVICE TO THE COMMUNITY IN THE AREA OF ACUTE INPATIENT CARE AND SKILLED SWING BED REHABILITATION THE ORGANIZATION ALSO PROVIDES SOCIAL SERVICES BY PROVIDING EMOTIONAL, SOCIAL, AND ECONMOIC SUPPORT/REFERRAL TO RESIDENTS AND FAMILIES, PEDIATRICS, SURGERY, EMERGENCY CARE, CARDIAC REHAB, OUTPATIENT, OUTREACH AND INPATIENT CARE. THE HOSPITAL HAD 10,326 OUTPATIENT VISITS AND 928 MED/SURGERY AND SSB DAYS. THE ORGANIZATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND EQUIVALENT SERVICE STATISTICS. THE AMOUNT OF CHARGES FOREGONE, BASED ON ESTABLISHED RATES, WAS $13,000 FOR THE YEAR ENDED SEPTEMBER 30, 2022.

4B (Expenses $ 6651054 including grants of $ 10027) (Revenue $ 5541617)
MADISON LUTHERAN HOME IS A 51 BED SKILLED NURSING FACILITY. IT WAS ORIGINALLY CONSTRUCTED IN 1952 AND OVER THE YEARS IT HAS CONTINUALLY BEEN ADDED ONTO. THE ENTIRE FACILITY ONCE WAS A 176 BED FACILITY, BUT WAS DOWNSIZED TO 80 BEDS IN ORDER TO ACCOMMODATE MORE SINGLE ROOMS FOR RESIDENTS. DUE TO STAFFING SHORTAGES THE FACILITY WAS REDUCED TO 65 BEDS IN MAY 2015. IN JULY 2019, LICENSED BEDS WERE REDUCED FROM 65 TO 56 TO RESIZE TO AVERAGE OCCUPANCY AND STAFFING SHORTAGES. RESIDENTS MOVED INTO A NEWLY BUILT WING ON AUGUST 18, 2021 TO PROVIDE A MORE HOME LIKE ATMOSPHERE. REMODELING CONTINUES ON A NEW CHAPEL, BEAUTY SHOP, ENTRY AND BISTRO. ALSO, MADISON LUTHERAN HOME UNDERWENT A MAJOR RENOVATION THAT STARTED IN 2019 AND FINISHED IN 2022. THE NURSING HOME PROVIDES QUALITY CARE OF THE RESIDENTS BY ASSISTING THE RESIDENTS TO ACHIEVE THEIR HIGHEST LEVEL OF FUNCTION AND PROVIDING A MORE HOME-LIKE ATMOSPHERE. NURSING HOME OCCUPANCY AT SEPTEMBER 30, 2022 WAS 39 RESIDENTS.

4C (Expenses $ 2836464 including grants of $ 4276) (Revenue $ 2332240)
THE MEDICAL STAFF AT THE CLINIC CONSISTS OF TWO M.D.'S , TWO PA-C'S, AND TWO NURSE PRACTIONERS AVAILABLE 5-DAYS-A-WEEK AND HALF OF SATURDAY. THE CLINIC WORKS WITH THE NURSING STAFF TO PROVIDE QUALITY CARE TO ITS PATIENTS. ATTACHED DIRECTLY TO THE MADISON HOSPITAL, THE CLINIC HAS EASY ACCESS TO MEDICAL SERVICES SUCH AS LAB, X-RAY, PHARMACY, AND OTHER DIAGNOSTIC SERVICES.

MADISON HOSPITAL
PART V, SECTION B, LINE 5: THE HOSPITAL CONDUCTED A COMMUNITY SURVEY, INTERVIEWED PROVIDERS AT OUR FACILITY, MEMBERS IN THE COMMUNITY OF MADISON, AND CONSISTENTLY MET WITH A PUBLIC HEALTH NURSE.

MADISON HOSPITAL
PART V, SECTION B, LINE 6B: MADISON HEALTHCARE SERVICES PARTNERED WITH COUNTRYSIDE PUBLIC HEALTH, PRAIRIE FIVE RIDES, LAC QUI PARLE COUNTY FAMILY SERVICE CENTER, LAC QUI PARLE VALLEY SCHOOL DISTRIC AND THE CITY OF MADISON IN ORDER TO ADDRESS THE HEALTH NEEDS OF THE REGION.

MADISON HOSPITAL
PART V, SECTION B, LINE 11: BY UTILIZING BOTH THE PRIMARY AND SECONDARY DATA WE RESEARCHED AND ANALYZED, THE COMMUNITY HEALTH NEEDS COMMITTEE WAS ABLE TO IDENTIFY AND PRIORITIZE HEALTH NEEDS IN OUR COMMUNITY. USING RESOURCES WITH OUR COMMUNITY MEMBERS AND PROFESSIONALS, WE DECIDED TO FOCUS ON THREE KEY HEALTH NEEDS THAT OUR COMMUNITY WOULD GREATLY BENEFIT FROM. THE THREE HEALTH NEEDS IDENTIFIED AND PRIORITIZED BY OUR COMMITTEE INCLUDE MENTAL HEALTH. MADISON HEALTHCARE SERVICES CONTINUES TO DEVOTE EXTENSIVE TIME AND MONEY TO PROVIDE COMPLEX THERAPY FOR MENTAL AND BEHAVIORAL HEALTHPATIENTS. IN 2018, WE CONTRACTED WITH OUR FIRST PSYCHIATRIC NP TO PROVIDE MEDICINE MANAGEMENT TO PATIENTS NEEDING THESE SERVICES. SHORTLY AFTER THE ADDITION OF OUR PSYCHIATRIC NP, WE ADDED A LICENSED INDEPENDENT CLINIC SOCIAL WORKER TO BEGIN COUNSELING SERVICES IN OUR CLINIC AND CARE CENTER. KNOWING THE NEED FOR MENTAL HEALTH SERVICES IN OUR COMMUNITY IS ONGOING, MHS OFFERS A LICENSED COUNSELOR AND PSYCHIATRIC NP THAT SEE PATIENTS IN THE CLINIC THREE DAYS EACH WEEK TO PROVIDE CONSISTENT AND COMPASSIONATE CARE. BOTH PROVIDERS ARE DEVOTED TO THE HEALTH OF THOSE THEYTREAT, AND THEIR SERVICES CONTINUE TO BE VERY SUCCESSFUL. MHS ALSO HAS PARTNERSHIPS WITH LOCAL SCHOOL DISTRICTS TO ENSURE THAT MENTAL HEALTH SERVICES ARE REACHING CHILDREN AND YOUNG ADULTS IN OUR COMMUNITIES. THERE IS ALSO AN AREA MENTAL HEALTH PROVIDER GROUP TO PROVIDE SUPPORT AND RESOURCES FOR THE MENTAL HEALTH PROVIDERS. IN ADDITION TO THE MENTAL HEALTH PROVIDER GROUP, WE HAVE A MENTAL HEALTH SUPPORT GROUP FOR PATIENTS THAT IS PROVING TO BE VERY BENEFICIAL. MHS WILL CONTINUE TO GROW THE SERVICES THEY PROVIDE FOR ALL MENTAL HEALTH PATIENTS AND IS DEDICATED TO DOING SO.2. OBSTETRICS & GYNECOLOGY: IN AN EFFORT TO KEEP AS MANY SERVICES LOCAL FOR THE PATIENTS THAT MHS SERVES, A CONTRACT WAS SIGNED WITH AN OB/GYN PHYSICIAN. MHS WILL BEGIN PROVIDING MONTHLY OB/GYN SERVICES STARTING IN SEPTEMBER 2022. WOMEN'S HEALTH IS A TOP PRIORITY OF MHS AND ONE THAT WILL CONTINUE TO BE AN AREA OF GROWTH WITH THE ADDITION OF DR. LISA BAKER. OFFICE PROCEDURES SUCH AS COLPOSCOPIES, BIOPSIES, PAP SMEARS, IUD INSERTIONS AND REMOVALS, ETC. WILL BE PROVIDED, ALONG WITH FULL CONSULTATIVE SERVICES. GYNECOLOGY WILL BE THE MAIN FOCUS OF THIS NEW SERVICE LINE; HOWEVER, OBSTETRIC PATIENTS WILL ALSO BE ABLE TO BE SEEN IN MADISON PRIOR TO DELIVERY. DUE TO LOW VOLUMES, MHS DISCONTINUED NEWBORN DELIVERIES IN 2018, HOWEVER, PRENATAL SERVICES ARE STILL PROVIDED IN OUR CLINIC. WE ARE EXCITED TO START THIS NEW SERVICE LINE AND LOOK FORWARD TO PROVIDING EXCEPTIONAL CARE.3. HEALTH & WELLNESS EDUCATIONMHS IS DEDICATED TO PROVIDING PATIENT EDUCATION TO ENSURE ALL PATIENTS NEEDS ARE MET AND QUESTIONS ARE ANSWERED REGARDING THEIR HEALTH. WE PROVIDE MONTHLY RADIO SPOTS BY VARIOUS PROVIDERS ON SPECIFIC HEALTH TOPICS TO HELP EDUCATE ON SPECIFIC HEALTH QUESTIONS. WEEKLY NEWSPAPER ARTICLES ARE WRITTEN REGARDING SPECIFIC HEALTH TOPICS AND SHARED WITH THE LOCAL NEWSPAPER FOR PUBLICATION. ALONG WITH THE BROAD EDUCATION THAT IS PROVIDED, EACH PATIENT THAT IS SEEN IN OUR CLINIC OR HOSPITAL IS GIVEN AN EDUCATION SHEET AT THE CONCLUSION OF THEIR APPOINTMENT TO HELP THE PATIENT UNDERSTAND EXACTLY WHAT THE CONDITION ENTAILS THAT THEY WERE BEING TREATED FOR. VARIOUS COMMUNITY SUPPORT GROUPS ARE AVAILABLE AND PROVIDE SUPPORT AND EDUCATION REGARDING MANY MEDICAL CONDITIONS, OBSTETRICS & GYNECOLOGY, AND HEALTH & WELLNESS EDUCATION.

MADISON HOSPITAL
PART V, SECTION B, LINE 13H: IF THE APPLICATION IS NOT RETURNED OR RETURNED INCOMPLETE, OTHER PATIENT MARKERS CAN BE USED TO APPROVE THE PATIENT FOR CHARITY CARE, SUCH AS WIC, FOOD STAMPS, FREE LUNCHES, MEDICAL ASSISTANCE, AND LOW-INCOME HOUSING. PATIENTS WHO MEET PRESUMPTIVE ELIGIBILITY CRITERIA MAY BE GRANTED FINANCIAL ASSISTANCE WITHOUT COMPLETING AN APPLICATION.

MADISON HOSPITAL
PART V, SECTION B, LINE 16J: WHEN IT HAS BEEN DISCOVERED THAT PATIENTS ARE HAVING DIFFICULTIES PAYING THEIR BILL AND PRIVATE PAY PATIENTS NOT MAKING PAYMENTS, THE PATIENT IS CALLED TO MAKE PAYMENT ARRANGEMENTS AND UPON DISCUSSION WITH THEM, THE HOSPITAL WILL MAIL THEM THE CHARITY CARE APPLICATION. IN ADDITION, ON THE ORGANIZATION'S WEBSITE UNDER THE FINANCIAL INFORMATION PAGE IT IS INDICATED THAT AN APPLICATION FOR CHARITY CARE IS AVAILABLE AND THAT ASSISTANCE WITH THE APPLICATION FOR FINANCIAL ASSISTANCE IS AVAILABLE UPON REQUEST.

PART I, LINE 3C:
FOR A PERSON TO QUALIFY FOR CHARITY CARE UNDER MADISON HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICY, AN INDIVIDUAL MUST RESIDE WITHIN A 50-MILE RADIUS OF THE HOSPITAL, HAVE FAMILY NET ASSETS LESS THAN $10,000, HAVE INCOME BELOW 275% OF FEDERAL POVERTY GUIDELINES, AND EITHER SUBMIT A COMPLETE APPLICATION OR BE PROVEN TO QUALIFY THROUGH PRESUMPTIVE DETERMINATIONS. AN INDIVIDUAL IS PRESUMPTIVELY ELIGIBLE FOR ASSISTANCE IF THEY EXPIRE WITHOUT AN ESTATE, WERE ON MEDICAL ASSISTANCE OR SIMILAR COVERAGE WITHIN THE PAST 12 MONTHS AND HAVE NO CHANGE IN EMPLOYMENT STATUS, OR FILED AND WERE APPROVED FOR BANKRUPTCY.

PART I, LINE 7:
THE COST-TO-CHARGE RATIO WAS DERIVED USING WORKSHEET 2 FROM THE IRS TO CALCULATE THE AMOUNTS INCLUDED ON LINES 7A AND 7B. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS INCLUDED ON LINE 7E AND HEALTH PROFESSIONAL EDUCATION ARE REPORTED AT COST.

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 $ 265,460.

PART III, LINE 2:
BAD DEBT EXPENSE IS CALCULATED UTILIZING DIRECT BAD DEBT COSTS FROM NONPAYMENT AFTER CONTRACTUAL DISCOUNTS AND PAYMENTS HAVE BEEN RECEIVED. THE STANDARD FORMULA FOR ACCOUNTS RECEIVABLE HAS BEEN UTILIZED FOR ANY OUTSTANDING ACCOUNTS AFTER CONTRACTUAL DISCOUNTS WERE TAKEN.

PART III, LINE 3:
DUE TO THE PUBLIC SHOWING, ADVERTISEMENT, PREQUALIFICATION, AND FOLLOW-UP NOTIFICATIONS OF OUR FINANCIAL ASSISTANCE POLICY VIA OUR BILLING PROCEDURES, WE DO NOT FEEL THAT THE IMPACT IS ABOVE ZERO.

PART III, LINE 4:
"THE ORGANIZATION'S BAD DEBT EXPENSE IS DISCUSSED IN THE ""PATIENT AND RESIDENT ACCOUNTS RECEIVABLE"" SECTION OF NOTE 1 TO THE FINANCIAL STATEMENTS, ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS."

PART III, LINE 8:
THE MEDICARE SHORTFALL OF $1,106,705 IS MADE UP MOSTLY OF PATIENT DEDUCTIBLES AND COINSURANCE. IF WE BACK THESE AMOUNTS OUT OF THE SHORTFALL, WE ARE LEFT WITH A TRUE SHORTFALL OF $0. THIS AMOUNT IS A RESULT OF THE FEDERAL GOVERNMENT'S SEQUESTRATION IMPLEMENTED BACK IN THE SUMMER OF 2016, OF WHICH WOULDN'T BE TREATED AS COMMUNITY BENEFIT.THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WERE DERIVED FROM THE 2022 FILED MEDICARE COST REPORT.

PART III, LINE 9B:
IF PATIENTS HAVE COMPLETED ALL PAPERWORK AND QUALIFY FOR CHARITY CARE, THE PATIENT IS NOT BILLED FOR ANY BALANCE AND ACCOUNT IS WRITTEN OFF. IF THE PATIENT HAS MEDICAL ASSISTANCE, THAT PROGRAM IS BILLED FOR CHARGES AND THE PAYMENT IS CONSIDERED PAYMENT IN FULL, UNLESS MEDICAL ASSISTANCE NOTIFIES US THAT THE PATIENT HAS RESPONSIBILITY FOR SPEND DOWN OR CO-PAY PAYMENTS.MADISON HEALTHCARE SERVICES WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE IF THE PERSON QUALIFIES FOR FINANCIAL ASSISTANCE. REASONABLE EFFORT WILL BE TAKEN TO REQUEST AND ASSIST IN COMPLETING APPLICATION, INCLUDING MEETING WITH INDIVIDUAL AND ASSISTING WITH THE APPLICATION PROCESS.IF THE INDIVIDUAL FAILS TO SUBMIT THE CHARITY CARE APPLICATION WITHIN 120 DAYS OF THE FIRST BILLING STATEMENT THE FACILITY HAS THE OPTION TO PROCEED WITH COLLECTION PROCESS. AT LEAST 30 DAYS PRIOR TO INITIATING THE COLLECTION PROCESS A WRITTEN NOTICE WILL BE PROVIDED INDICATING IF INDIVIDUAL DOES NOT SUBMIT THE APPLICATION OR PAY THE AMOUNT DUE BY INDICATED DEADLINE THE ACCOUNT WILL BE SENT TO A COLLECTION AGENCY. THE FACILITY HAS THE DISCRETION TO CONSIDER FOR CHARITY CARE WITHOUT COMPLETION OF CHARITY CARE APPLICATION.IF THE INDIVIDUAL COMPLETES THE APPLICATION WITHIN THE 240 DAY REQUIREMENT FOLLOWING TREATMENT, THE FACILITY WILL SUSPEND ANY COLLECTION EFFORTS. IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION WRITTEN NOTICE WILL BE PROVIDED WITH ADDITIONAL INFORMATION NEEDED AND REASONABLE TIME WILL BE GIVEN TO SUBMIT MISSING INFORMATION.

PART VI, LINE 2:
TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY MHS FIRST PERFORMED ADEMOGRAPHIC ANALYSIS OF LAC QUI PARLE COUNTY USING DATA FROM THE U.S.CENSUS BUREAU AND COUNTY HEALTH RANKINGS. TO FURTHER THE ASSESSMENTADDITIONAL RESOURCES WERE UTILIZED, INCLUDING THE MN DEPARTMENT OF HEALTHAND COUNTRYSIDE PUBLIC HEALTH. MHS FINISHED THE EVALUATION WITH PRIMARYDATA COMPILED THROUGH A COMMUNITY SURVEY. MHS COLLABORATED WITHCOUNTRYSIDE PUBLIC HEALTH, PRAIRIE FIVE RIDES, LAC QUI PARLE COUNTY FAMILYSERVICE CENTER, THE DIABETES FOUNDATION, AND THE CITY OF MADISON. USINGTHE INFORMATION COLLECTED, THE COMMUNITY HEALTH NEEDS COMMITTEE DETERMINEDTHE HEALTH NEEDS FOR THE COUNTY. THE NEXT STEP FOR MHS WAS TO FORMCOLLABORATIONS WITH THE LAC QUI PARLE HEALTH NETWORK, LAC QUI PARLE SCHOOLDISTRICT, AND THE MADISON HEALTHCARE AUXILIARY TO APPROACH AND EXECUTE ANIMPLEMENTATION STRATEGY. THE COMMUNITY HEALTH NEEDS COMMITTEE WILL DILIGENTLY MONITOR OUR CURRENT PROGRAMS TO ENSURE THEY ARE MEETING OUR IDENTIFIED COMMUNITY NEEDS. THE EXECUTION OF OUR IMPLEMENTATION PLAN HAS EXPERIENCED MANY SUCCESSES AND CONTINUES TO PROGRESS. OUR FOCUS WILL BE TO STRENGTHEN AND GROW OUR COLLABORATIONS WITH OTHER ORGANIZATIONS TO BETTER OUR EDUCATION, OUTREACH, AND RESOURCES FOR THE COMMUNITIES WE SERVE. MADISON HEALTHCARE SERVICES VALUES QUALITY ON ALL LEVELS AND WORKS DILIGENTLY TO IDENTIFY WAYS TO MAKE IMPROVEMENTS ON AN ONGOING BASIS. SERVICES ARE MONITORED THROUGH OUR QUALITY COUNCIL, INTERNAL AND EXTERNAL REVIEWS, AND PARTICIPATION IN STATE AND FEDERAL QUALITY REPORTING MEASURES.

PART VI, LINE 7, REPORTS FILED WITH STATES
MN

PART VI, LINE 3:
THE ORGANIZATION INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THESE PROGRAMS IN THE PATIENT ADMISSION PACKET AND ON THE HOSPITAL'S WEBSITE. THE WEBSITE INDICATES THE HOSPITAL WILL FILE YOUR INSURANCE CLAIMS, CAN SET UP AUTOMATIC BANK WITHDRAWALS, THE HOSPITAL ACCEPTS CREDIT CARD PAYMENTS, YOU CAN REQUEST CHARITY CARE APPLICATIONS, THE HOSPITAL DOES NOT CHARGE FINANCE CHARGES, THE HOSPITAL ACCEPT PAYMENT ARRANGEMENTS, ITEMIZED BILL AVAILABLE UPON REQUEST AND GLAD TO ANSWER YOUR QUESTIONS.THE HOSPITAL SENDS 3 STATEMENTS TO PATIENTS WITH PRIVATE PAY BALANCES, ALSO SENDS 3 LETTERS INDICATING PAST DUE BALANCE AND TO PLEASE PAY OR YOUR ACCOUNT WILL BE SENT TO COLLECTION. MANY TIMES A PHONE CALL IS MADE TO PATIENT ASKING THEM TO SET UP PAYMENT ARRANGEMENT OR ASKING IF THEY WANT CHARITY CARE APPLICATION OR HOW THE HOSPITAL CAN ASSIST THEM TO GET THEIR BALANCE PAID PRIOR TO SENDING TO COLLECTION AGENCY. THE PAST DUE LETTERS SENT TO PATIENTS REQUEST THEM TO CALL THE HOSPITAL TO DISCUSS THEIR PAST DUE BILL AT WHICH TIME THE ASSISTANCE PROGRAMS CAN BE EXPLAINED. THE HOSPITAL DOES NOT CHARGE FINANCE CHARGES TO PATIENTS' UNPAID BALANCE. THE ORGANIZATION BELIEVES THIS IS A COMMUNITY SERVICE AND ASSISTS THOSE PATIENTS THAT CAN ONLY MAKE SMALL PAYMENTS - OTHERWISE FINANCE CHARGES COULD BE MORE THAN THEIR MONTHLY PAYMENT AND DISCOURAGE THEM FROM MAKING ANY PAYMENTS.PRIVATE PAY INPATIENTS ARE VISITED BY OFFICE STAFF AND GIVEN FORMS TO APPLY FOR MEDICAL ASSISTANCE.

PART VI, LINE 4:
THE AREA BEING SERVED BY THE MADISON HOSPITAL AND LAC QUI PARLE CLINIC IS PRIMARILY A RURAL AND AGING COMMUNITY. THE PATIENT BASE IS MADE UP OF BOTH WORKING CLASS AND FARMERS. THE COUNTIES THAT WE SERVE ARE LAC QUI PARLE, BIG STONE AND SOME BORDER COUNTIES OF SOUTH DAKOTA. THE CLOSEST FACILITIES ARE 25 MILES AWAY IN CANBY, DAWSON, APPLETON OR ORTONVILLE. THE AVERAGE INDIVIDUAL INCOME IS APPROXIMATELY $35,859, GROSS. ON AVERAGE, THE POVERTY LEVEL IN THE COUNTY IS ABOUT 8.32% WITH 43.72% OF THE POPULATION HAVING LESS THAN 9TH GRADE EDUCATION TO HIGH SCHOOL GRADUATE DEGREE. 96.03% OF THE POPULATION IS WHITE. 24.09% OF THE FAMILIES IN THE HOSPITALS SERVICE AREA ARE ON MEDICAID/UCARE PMAP/BLUE PLUS PMAP/PRIMEWEST PAMP. TO FURTHER EVALUATE THE DEOMOGRAPHICS OF THE COUNT WE COMPILED DATE FRINGE COUNTY HEALTH RANKINGS. GAPS PUT A LIMIT ON THE HOSPITAL'S ABILITY TO ASSESS ALL OF THE COMMUNITY NEEDS. IN OUR PARTICULAR SITUATION, INFORMATION GAPS THAT MAY HAVE OCCURRED IN OUR ASSESSMENT IS THAT OUR NEEDS MAY HAVE DEVELOPED ON THE BASIS OF OPINIONS FROM OUR COMMUNITY HEALTH NEEDS COMMITTEE AND THOSE THAT COMPLETED THE SURVEY. THESE OPINIONS MAY NOT REFLECT THE TRUE NEEDS OF THE POPULATION. AFTER REVIEWING THESE STATISTICS, WE ACKNOWLEDGED THAT LAC QUI PARLE COUNTYFAILS TO MEET THE NATIONAL BENCHMARK IN SOME HEALTH BEHAVIORS BUT HAS ALSO IMPROVED OR HAS NARROWED THE GAP BETWEEN THE NATIONAL BENCHMARKS. ADULT OBESITY IS AT 35% IN THE COUNTY, WHICH IS ONLY 5% MORE THAN THE NATIONAL BENCHMARK. PHYSICAL INACTIVITY WITHIN THE COUNTY IS AT 23%, WHICH IS THE SAME AS THE NATIONAL BENCHMARK. ACCESS TO EXERCISE OPPORTUNITIES IS AT 27% COMPARED TO THE NATIONAL BENCHMARK OF 86%. FREQUENTMENTAL DISTRESS IS 13% FOR BOTH LAC QUI PARLE COUNTY AND THE NATIONAL BENCHMARK. THE STATISTICS SHOW THAT 7% OF LAC QUI PARLE COUNTY ADULTS ARE UNINSURED. PRIMARY CARE PHYSICIANS ARE 1,100 PEOPLE PER PHYSICIAN. OTHER SOCIAL AND ECONOMIC FACTORS OF LAC QUI PARLE COUNTY INCLUDE A HIGH SCHOOL GRADUATION RATE OF 93% AND AN UNEMPLOYMENT RATE OF 4.7%. OVERALL, LAC QUI PARLE COUNTY RANKS 21ST ON HEALTH FACTORS OUT OF 87 COUNTIESIN MINNESOTA.

PART VI, LINE 5:
THE HOSPITAL'S BOARD IS COMPRISED OF PERSONS WHO RESIDE IN THE COMMUNITYAND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY SUCH AS DR. CLINT BONN, CHIROPRACTOR. DR. BONN UTILIZED MADISON HOSPITAL LABORATORY FOR DOT DRUG TESTING AND MADISON HOSPITAL RADIOLOGY FOR ALL X-RAY AND CT STUDIES. THREE TIMES A YEAR, THE RADIOLOGY DEPARTMENT HOLDS VASCULAR SCREENINGS IN WHICH COMMUNITY MEMBERS MAY HAVE VASCULAR SCREENINGS TO DETECT STROKES, PERIPHERAL VASCULAR DISEASE, AND ABDOMINAL AORTIC ANEURYSMS. THIS IS A CASH BASED SCREENING AND IS AVAILABLE AT A SUBSTANTIALLY REDUCED RATE AND A DOCTOR'S ORDER IS NOT REQUIRED. MADISON HOSPITAL LAB OFFERS DIRECT ACCESS LAB TESTING TO ITS COMMUNITY MEMBERS. THIS IS A CASH BASED PROGRAM WHERE LAB TESTS ARE OFFERED ON A CASH BASIS AT A SUBSTANTIALLY REDUCED RATE. LAST YEAR, OUR USERS SAVED OVER $12,000. MADISON HOSPITAL AND LAC QUI PARLE CLINIC DONATE ALL UNUSED MEDICAL EQUIPMENT TO A MISSION FOR MEDICAL USE. ALL EXPIRED LABORATORY SUPPLIES ARE SENT TO THE MEDICAL LAB TECHNICIAN PROGRAMS FOR USE IN THEIR STUDENT LABS. MADISON HOSPITAL IS CONSTANTLY STRIVING TO ADD NEW SERVICES, INCLUDING OUTREACH SERVICES TO BETTER SERVE THE NEEDS OF OUR COMMUNITY. A LEADERSHIP TEAM HAS BEEN FORMED TO MEET THE COMMUNITY NEEDS, CONTINUE TO LOOK AT ADDING NEW SERVICES, CONTINUE TO LOOK AT UPDATING OUR CURRENT FACILITY, AND ASKING FOR COMMUNITY INVOLVEMENT IN FINAL DECISION MAKING. WITH OUR AGING POPULATION, WE STRIVE TO BRING THE SERVICES TO THE PATIENTS, RATHER THAN THE PATIENTS HAVING TO DRIVE HOURS FROM HOME TO GET THE SERVICES. MADISON HOSPITAL PROVIDED HEALTH CARE SCREENINGS AT REDUCED RATES TO THECOMMUNITY.