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Nonprofiteer
← ELY-BLOOMENSON COMMUNITY HOSPITAL

Form 990 for tax year 2022

Filed by ELY-BLOOMENSON COMMUNITY HOSPITAL.

Totals

Total revenue
$31,195,531
Total expenses
$30,468,212
Contributions and grants received
$903,426
Grants paid
$85,119
Program service revenue
$29,907,971
Investment income
$293,528
Other revenue
$90,606
Total assets, end of year
$29,881,505
Total liabilities, end of year
$12,463,218
Net assets or fund balances, end of year
$17,418,287
Program services expenses (Part IX)
$26,009,109
Management and general expenses
$4,459,103
Fundraising expenses
$0
Program service expenses (Part III)
$26,009,109

Program services were 85.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $615,329

  • 1f · All other contributions, gifts and grants

    $288,097

  • 2a · Program service revenue: PATIENT SERVICE

    total $24,617,533 · related or exempt $24,617,533

  • 2b · Program service revenue: RETAIL PHARMACY

    total $4,914,082 · unrelated business $4,914,082

  • 2c · Program service revenue: EQUITY IN EARNINGS OF AFFILIATES

    total $376,356 · related or exempt $376,356

  • 3 · Investment income

    total $317,569 · excluded $317,569

  • 6a · Gross rents

    real property $28,703

  • 6b · Less rental expenses

    real property $1,709

  • 6c · Rental income or loss

    real property $26,994

  • 6d · Net rental income or loss

    total $26,994 · excluded $26,994

  • 7a · Gross sales of assets other than inventory

    securities $10,130 · other assets $200

  • 7b · Less cost or other basis and sales expenses

    securities $11,908 · other assets $22,463

  • 7c · Gain or loss

    securities -$1,778 · other assets -$22,263

  • 7d · Net gain or loss

    total -$24,041 · excluded -$24,041

  • 11a · Other revenue: OTHER OPERATING

    total $63,612 · related or exempt $63,612

  • 11e · Other revenue, total

    $63,612

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $85,119 · program services $85,119

  • 5 · Compensation of officers, directors and key employees

    total $790,307 · program services $379,059 · management and general $411,248

  • 7 · Other salaries and wages

    total $8,614,281 · program services $7,538,223 · management and general $1,076,058

  • 8 · Pension plan contributions

    total $289,580 · program services $253,919 · management and general $35,661

  • 9 · Other employee benefits

    total $1,604,625 · program services $1,429,256 · management and general $175,369

  • 10 · Payroll taxes

    total $661,187 · program services $559,117 · management and general $102,070

  • 11b · Fees: legal

    total $88,798 · management and general $88,798

  • 11c · Fees: accounting

    total $495,281 · management and general $495,281

  • 11d · Fees: lobbying

    total $2,123 · management and general $2,123

  • 11g · Fees: other

    total $4,964,165 · program services $4,522,427 · management and general $441,738

  • 12 · Advertising and promotion

    total $57,898 · program services $2,242 · management and general $55,656

  • 13 · Office expenses

    total $1,248,599 · program services $1,028,185 · management and general $220,414

  • 14 · Information technology

    total $756,567 · program services $412,704 · management and general $343,863

  • 16 · Occupancy

    total $268,389 · program services $268,389

  • 17 · Travel

    total $104,789 · program services $37,727 · management and general $67,062

  • 20 · Interest

    total $208,142 · management and general $208,142

  • 22 · Depreciation, depletion and amortization

    total $1,102,713 · program services $1,011,396 · management and general $91,317

  • 23 · Insurance

    total $119,686 · management and general $119,686

  • 24a · Other expenses: UBIT

    total $3,698 · management and general $3,698

  • 24b · Other expenses: DRUGS

    total $5,695,871 · program services $5,695,871

  • 24c · Other expenses: LEASE EXPENSE

    total $1,200,734 · program services $1,200,734

  • 24d · Other expenses: REPAIRS & MAINTENANCE

    total $655,543 · program services $627,494 · management and general $28,049

  • 24e · All other expenses

    total $1,450,117 · program services $957,247 · management and general $492,870

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $9,405,423 · end of year $3,010,223

  • 4 · Accounts receivable

    beginning of year $3,428,871 · end of year $4,047,226

  • 7 · Other notes and loans receivable

    end of year $250,000

  • 8 · Inventories for sale or use

    beginning of year $1,081,110 · end of year $1,136,806

  • 9 · Prepaid expenses and deferred charges

    beginning of year $209,594 · end of year $272,281

  • 10a · Land, buildings and equipment: cost or other basis

    $26,892,258

  • 10b · Land, buildings and equipment: accumulated depreciation

    $20,954,771

  • 10c · Land, buildings and equipment, net

    beginning of year $6,253,595 · end of year $5,937,487

  • 11 · Investments: publicly traded securities

    beginning of year $3,839,657 · end of year $9,702,135

  • 15 · Other assets

    beginning of year $1,990,708 · end of year $5,525,347

  • 17 · Accounts payable and accrued expenses

    beginning of year $2,656,566 · end of year $2,305,258

  • 19 · Deferred revenue

    beginning of year $150,086 · end of year $109,154

  • 20 · Tax-exempt bond liabilities

    beginning of year $6,962,204 · end of year $6,235,667

  • 24 · Unsecured notes and loans payable

    beginning of year $22,036 · end of year $4,528

  • 25 · Other liabilities

    beginning of year $0 · end of year $3,808,611

  • 27 · Net assets without donor restrictions

    beginning of year $16,418,066 · end of year $17,418,287

Mission and programs · 2022

Mission

TO PROVIDE HOSPITAL SERVICES FOR THE ELY COMMUNITY AND SURROUNDING AREA.

Activities or mission (Part I)

ELY-BLOOMENSON COMMUNITY HOSPITAL IS COMMITTED TO CARING FOR AND ENHANCING THE HEALTH AND WELL BEING OF THE COMMUNITY IT SERVES.

  • HOSPITAL SERVICES PROVIDED FOR THE ELY COMMUNITY AND SURROUNDING AREA. ELY-BLOOMENSON COMMUNITY HOSPITAL (EBCH), RECOGNIZED BY THE FEDERAL & STATE OF MINNESOTA GOVERNMENTS AS A CRITICAL ACCESS HOSPITAL, IS THE ONLY LOCAL HEALTHCARE CENTER SERVING ELY AND SURROUNDING COMMUNITIES BORDERING THE VAST ACREAGE OF BOUNDARY WATERS CANOE AREA WILDERNESS. UNDER ORIGINAL FEDERAL RULES EBCH WOULD HAVE BEEN ONLY ONE OUT OF SEVEN HOSPITALS IN MINNESOTA THAT WOULD HAVE QUALIFIED FOR CRITICAL ACCESS HOSPITAL STATUS. THE HOSPITAL BOASTS: IN AND OUTPATIENT HOSPITAL NURSING SERVICE, IN-HOUSE LABORATORY, AN ON-SITE RETAIL PHARMACY, PHYSICAL AND OCCUPATIONAL THERAPY, CHEMOTHERAPY, A FULLY-STAFFED 24-7 RADIOLOGY DEPARTMENT, A PROFESSIONAL ANESTHESIA TEAM, SWING BED CARE FOR PATIENTS WHO NO LONGER REQUIRE ACUTE CARE HOSPITALIZATION, AND A 24-7 EMERGENCY ROOM. DURING THE FY2023 EBCH PERFORMED 475 SURGICAL PROCEDURES, 51,514 LABORATORY TESTS, 8,524 RADIOLOGICAL EXAMS, AND 3,700 EMERGENCY ROOM VISITS. IN ADDITION, 316 PEOPLE WERE ADMITTED FOR INPATIENT CARE. 721 DAYS OF CARE WERE PROVIDED FOR INPATIENTS AND 250 DAYS OF CARE WERE PROVIDED TO SWING BED PATIENTS, 9,377 OUTPATIENTS WERE SEEN, 7,258 MODALITIES WERE PERFORMED IN OT AND PT, AND 1,791 MODALITIES WERE PERFORMED IN CARDIAC REHAB.

    Expenses $26,009,109 · Grants $85,119 · Revenue $29,971,583

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • JO LANGAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • MARY ANN SMITH

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • BARB SODERBERG

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • SCOTT KELLERMAN

    DIRECTOR UNTIL 12/31/22

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • JOHN SAW

    DIRECTOR BEG. 1/1/23

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • MIKE PECHEK

    TREAS.TIL 12/31/22- DIR. TIL 1/31/23

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • TODD HEIMAN

    DIR. TIL 12/31/22-TREAS. BEG. 1/1/23

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • KELLY KLUN

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • DEVON LUTHENS

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    1 + 0.2 related

  • TIM RILEY

    PRESIDENT

    Total calculated
    $0
    Hours/week
    1.5 + 0.2 related

  • PATTI BANKS

    CEO

    Total calculated
    $259,283
    From this org
    $247,560
    From related orgs
    $0
    Other
    $11,723
    Hours/week
    39.7 + 0.3 related

    Schedule J breakdown matched by us

    Base
    $247,560
    Bonus
    $0
    Other
    $0
    Deferred
    $7,565
    Nontaxable benefits
    $4,158
    Filer's total
    $259,283

  • CURTIS BACH

    CFO UNTIL 10/31/22

    Total calculated
    $158,910
    From this org
    $139,815
    From related orgs
    $0
    Other
    $19,095
    Hours/week
    39.7 + 0.3 related

    Schedule J breakdown matched by us

    Base
    $139,815
    Bonus
    $0
    Other
    $0
    Deferred
    $4,283
    Nontaxable benefits
    $14,812
    Filer's total
    $158,910

  • BROCK URIE

    CMO/PHYSICIAN

    Total calculated
    $346,880
    From this org
    $346,880
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $346,880
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $346,880

  • SAM RICE

    PHYSICIAN

    Total calculated
    $267,556
    From this org
    $225,415
    From related orgs
    $0
    Other
    $42,141
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $225,415
    Bonus
    $0
    Other
    $0
    Deferred
    $7,251
    Nontaxable benefits
    $34,890
    Filer's total
    $267,556

  • SARAVANA BALARAMAN

    PHYSICIAN UNTIL 5/28/22

    Total calculated
    $188,909
    From this org
    $169,065
    From related orgs
    $0
    Other
    $19,844
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $169,065
    Bonus
    $0
    Other
    $0
    Deferred
    $5,178
    Nontaxable benefits
    $14,666
    Filer's total
    $188,909

  • BETH HARTSHORN

    PHARMACIST

    Total calculated
    $174,190
    From this org
    $155,016
    From related orgs
    $0
    Other
    $19,174
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $155,016
    Bonus
    $0
    Other
    $0
    Deferred
    $4,734
    Nontaxable benefits
    $14,440
    Filer's total
    $174,190

  • JOHN SCHINDELE

    PHARMACIST

    Total calculated
    $193,407
    From this org
    $154,277
    From related orgs
    $0
    Other
    $39,130
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $154,277
    Bonus
    $0
    Other
    $0
    Deferred
    $4,921
    Nontaxable benefits
    $34,209
    Filer's total
    $193,407

  • KARLA GRIZZARD

    RN

    Total calculated
    $191,091
    From this org
    $152,682
    From related orgs
    $0
    Other
    $38,409
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $152,682
    Bonus
    $0
    Other
    $0
    Deferred
    $5,258
    Nontaxable benefits
    $33,151
    Filer's total
    $191,091

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
6 June 2024
IRS schema version
2022v5.0
Source object
202421649349300812

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