TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) KYLE RICHARDS...................................................................... CEO (THRU DEC 2019)	40.00 ................. 0.00		X		400,749	0	59,544
(2) KENT MATTSON...................................................................... CEO	40.00 ................. 0.00		X		359,820	0	33,514
(3) FRITZ KARSNIA...................................................................... ANESTHESIA DIRECTOR	40.00 ................. 0.00			X	303,453	0	11,454
(4) JONATHAN ANDERSON...................................................................... CRNA	40.00 ................. 0.00			X	253,116	0	11,076
(5) JEFFERY OLSON...................................................................... CRNA	40.00 ................. 0.00			X	252,994	0	11,076
(6) JOY LINDGREN...................................................................... CMO (THRU JAN 2020)	40.00 ................. 0.00			X	262,551	0	907
(7) TYLER SCOTT...................................................................... CRNA	40.00 ................. 0.00			X	259,286	0	539
(8) LUCIA ANDERSON...................................................................... CNO/DIRECTOR OF SURGICAL SVCS	40.00 ................. 0.00		X		215,086	0	13,053
(9) DANIELLE LESMEISTER...................................................................... PRAIRIE RIDGE CEO	0.00 ................. 40.00		X		150,674	0	11,902
(10) WADE JYRKAS...................................................................... CIO	40.00 ................. 0.00		X		134,300	0	11,855
(11) KATIE JOHNSON...................................................................... VP OF MARKETING & COMMUNICATIONS	40.00 ................. 0.00		X		123,890	0	11,955
(12) LUKE DRAXTEN...................................................................... VP OF PHYSICIAN SERVICES	40.00 ................. 0.00		X		129,178	0	11,503
(13) CRYSTAL ADAMS...................................................................... TRUSTEE	4.00 ................. 1.70	X			0	660	0
(14) RICHARD LAMBERT...................................................................... TRUSTEE	4.00 ................. 1.50	X			0	660	0
(15) GENE WENSTROM...................................................................... TRUSTEE	4.00 ................. 2.50	X			0	660	0
(16) CAMIE PATTERSON...................................................................... CFO	40.00 ................. 0.00		X		0	0	0
(17) JOHN ERICKSON...................................................................... BOARD CHAIR	8.00 ................. 0.00	X	X		0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
LAKE REGION MEDICAL GROUP 712 S CASCADE STREET FERGUS FALLS,MN56538	PHYSICIAN SERVICES	29,896,976
MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS,MN58480	LAB SERVICES	766,188
HTK INC DBA HAILEY SAULT 394 SOUTH LAKE AVE SUITE 207 DULUTH,MN55802	MARKETING SERVICES	503,455
SODEXO CTM INC PO BOX 415000 NASHVILLE,TN37241	MAINTENANCE SERVICES	474,716
WITTKIEFFER INC 2015 SPRING ROAD SUITE 150 OAK BROOK,IL60523	INTERIM CFO SERVICES	466,934
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 23

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization LAKE REGION HEALTHCARE CORPORATION

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization LAKE REGION HEALTHCARE CORPORATION		Employer identification number 41-0730602

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization LAKE REGION HEALTHCARE CORPORATION			Employer identification number 41-0730602
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2019

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

6,177

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

6,177

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	LAKE REGION HEALTHCARE PAID A PERCENT OF THEIR MHA DUES FOR LOBBYING PURPOSES.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	3,078,849		3,078,849
b	Buildings ....	90,343,255	44,643,273	45,699,982
c	Leasehold improvements	161,387	62,390	98,997
d	Equipment ....	41,539,424	31,720,734	9,818,690
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				58,696,518

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)FUNDED DEPRECIATION				11,454,759
(2)WORKERS COMPENSATION INSURANCE DEPOSITS				116,858
(3)DUE FROM AFFILIATES				49,481
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				11,621,098

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	11,440,921
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART X, LINE 2:

LRHC IS ORGANIZED AS A MINNESOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THIS ENTITY IS REQUIRED ANNUALLY TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THIS ENTITY MAY BE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. LRHC FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. MEDICAL BUILDING IS A MINNESOTA LIMITED LIABILITY COMPANY SOLELY OWNED BY LRHC AND RECOGNIZED BY THE IRS FOR U.S. FEDERAL INCOME TAX PURPOSES AS A PASS-THROUGH ENTITY AND IS TREATED AS A "DISREGARDED ENTITY" FOR TAX PURPOSES AND WILL BE INCLUDED IN SCHEDULE R OF LRHC'S IRS FORM 990. THE CORPORATION BELIEVES THAT IT HAS APPROPRAITE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE, IF SUCH INTEREST AND PENALTIES ARE INCURRED.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 17500.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 21500.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	555,000		555,000	0.420 %
b	Medicaid (from Worksheet 3, column a) . . . . .	17,158,326	9,766,908	7,391,418	5.540 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	17,713,326	9,766,908	7,946,418	5.960 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	43,757		43,757	0.030 %
f	Health professions education (from Worksheet 5) . . .	791,746		791,746	0.590 %
g	Subsidized health services (from Worksheet 6) . . . .	34,886	24,214	10,672	0.010 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	27,000		27,000	0.020 %
j	Total. Other Benefits . .	897,389	24,214	873,175	0.650 %
k	Total. Add lines 7d and 7j .	18,610,715	9,791,122	8,819,593	6.610 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	3,450	3,450	0 %
3	Community support	30,763	30,763	0.020 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	39,994	39,994	0.030 %
8	Workforce development
9	Other
10	Total	74,207	74,207	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,268,025

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

23,328,747

Enter Medicare allowable costs of care relating to payments on line 5.....

28,336,523

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-5,007,776

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 LRH RAD ONC SERVICES	RADIATION ONCOLOGY	50.000 %	0 %	50.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)					Other (describe)
1	LAKE REGION HEALTHCARE CORPORATION 712 S CASCADE STREET FERGUS FALLS,MN56537 WWW.LRHC.ORG 00437	X	X	X	5 PROVIDER-BASED CLINICS AND 1 CANCER CENTER

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	LAKE REGION HEALTHCARE CORPORATION
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	LAKE REGION HEALTHCARE CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 175.000000000000%
and FPG family income limit for eligibility for discounted care of 215.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/

The FAP application form was widely available on a website (list url):

HTTP://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	LAKE REGION HEALTHCARE CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	LAKE REGION HEALTHCARE CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
LAKE REGION HEALTHCARE CORPORATION	PART V, SECTION B, LINE 5: LAKE REGION HEALTHCARE CORPORATION - LAKE REGION REFERRED TO THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) FRAMEWORK FOR GUIDANCE IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THIS COMMUNITY-WIDE PLANNING AND ACTION ORIENTED PROCESS WAS DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS IN PARTNERSHIP WITH THE PUBLIC HEALTH PRACTICE PROGRAM OFFICE OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. MAPP IS A COMMUNITY-DRIVEN PROCESS ROOTED ON PARTNERSHIP DEVELOPMENT. ASSESSMENT OF NEEDS AND ASSETS AND STRATEGIC PLANNING ON HOW TO EFFICIENTLY USE AVAILABLE RESOURCES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. LRH COMPLETED TWO ASSESSMENTS IN THE MAPP PROCESS: COMMUNITY THEMES AND STRENGTHS, AND COMMUNITY HEALTH STATUS. LRH ALSO HAD INPUT FROM COMMUNITY PARTNERS AND STAKEHOLDERS, ESPECIALLY PUBLIC HEALTH AND THOSE REPRESENTING THE UNDESERVED AND LOW-INCOME POPULATIONS.
LAKE REGION HEALTHCARE CORPORATION	PART V, SECTION B, LINE 11: IN THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, LAKE REGION HEALTHCARE CORPORATION IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS: MENTAL HEALTH, SUBSTANCE ABUSE, RESOURCE NAVIGATION AND CHRONIC DISEASES. IN FEBRUARY 2020, INITIAL COMMUNICATION CAME FROM THE MINNESOTA DEPARTMENT OF HEALTH REGARDING PREPARATION FOR THE SURGE OF COVID-19. INITIAL WORK INCLUDED SITUATIONAL AWARENESS, INVENTORY OF PERSONAL PROTECTIVE EQUIPMENT (PPE) IN STORAGE, ACTIVATION OF THE HIGH CONSEQUENCE INFECTIOUS DISEASE PLAN, AND COMMUNICATION THROUGHOUT ALL LEVELS OF THE ORGANIZATION. MANY MEASURES WERE IMPLEMENTED TO ENSURE HEALTHCARE WORKER AND PATIENT SAFETY THROUGHOUT THE PANDEMIC THROUGH EDUCATION, INCREASED MONITORING AND TESTING, AND UPDATING THE HOSPITAL'S FACILITIES TO INHIBIT THE SPREAD OF COVID-19 AND MANAGE THE INCREASE IN PATIENTS DUE TO THE DISEASE. DESPITE A HIGH NUMBER OF HOSPITALIZATIONS, THERE WERE VERY FEW HIGH-RISK EXPOSURES OF HEALTHCARE WORKERS OR PATIENTS, PRIMARILY RELATED TO UNIVERSAL PPE UTILIZATION.MENTAL HEALTH - IN 2020, LAKE REGION HEALTHCARE SUCCESSFULLY RECRUITED 3 NEW PSYCHIATRIC PRACTITIONERS, 2 PSYCHIATRISTS, AND 1 NURSE PRACTITIONER. THE ADDITION OF THESE PROVIDERS GREATLY IMPROVED ACCESS FOR OUR PATIENTS AND COMMUNITY MEMBERS. ADDITIONALLY, TO HELP US IMPROVE DEPRESSION MANAGEMENT, WE IMPLEMENTED A PROCESS TO INCREASE THE DEPRESSION SCREENING USING THE PATIENT HEALTH QUESTIONNAIRE -9 (PHQ-9) SCREENING TOOL AT OUR CLINICS. UNDERSTANDING THE EXTENSIVENESS OF THE ISSUE OF MENTAL HEALTH, WE WANTED TO ENSURE THAT WE CONTINUE TO COLLABORATE WITH OUR COMMUNITY PARTNERS AND STAKEHOLDERS TO HELP IDENTIFY OPPORTUNITIES TO IMPROVE ACCESS TO QUALITY MENTAL HEALTH CARE. DUE TO COVID-19, WE WERE ONLY ABLE TO MEET WITH COMMUNITY PARTNERS ONCE IN 2020. HOWEVER, WE PLAN ON CONTINUING TO BE PART OF THIS CONVERSATION AND HELP THE COMMUNITY HAVE ACCESS TO QUALITY MENTAL HEALTH CARE.IN ADDITION TO THESE PROGRAMS TO STRENGTHEN MENTAL HEALTH INITIATIVES WITHIN THE COMMUNITY, IN FISCAL YEAR 2020, LAKE REGION HEALTHCARE CORPORATION WORKED TO TRAIN COMMUNITY MEMBERS ON QPR (QUESTION, PERSUADE, AND REFER) GATE KEEPER TRAINING FOR SUICIDE PREVENTION, REFER APPROPRIATE PRENATAL OR POSTPARTUM PATIENTS TO THE COUNTY'S HOME VISITING PROGRAM, AND PROMOTE THRIVE AND PERSON-CENTERED CARE ACTIVITIES AMONG STAFF, PROVIDERS, AND THE COMMUNITY.SUBSTANCE ABUSE - CHEMICAL DEPENDENCE WAS ONE OF THE CONCERNS FREQUENTLY BROUGHT UP IN OUR FOCUS GROUP SESSIONS. AS IS THE CASE ACROSS THE ENTIRE COUNTRY, ADDICTION TO OPIOIDS, HEROIN AND METHAMPHETAMINE IS ALSO A GROWING THREAT IN OUR COMMUNITY. AS PART OF OUR RESPONSE, LAKE REGION HEALTHCARE IS ONE OF EIGHT PILOT SITES ACROSS THE STATE FOLLOWING THE TACKLING OPIOID USE WITH NETWORKS (TOWN) MODEL FUNDED THROUGH THE MINNESOTA DEPARTMENT OF HEALTH TO HELP PREVENT OPIOID MISUSE AND OVERDOSE. THE TOWN MODEL INTEGRATES PREVENTION AND TREATMENT STRATEGIES AT THE HEALTH CARE SYSTEM AND IN SURROUNDING COMMUNITY TO: (1) CREATE COORDINATED CLINICAL CARE TEAMS, (2) IMPROVE THE PRESCRIBING CULTURE BY PROVIDING EDUCATION TO PROVIDERS AND PHARMACISTS ON APPROPRIATE OPIOID AND NALOXONE PRESCRIBING AND DISPENSING, (3) INCREASE COORDINATION ACROSS COMMUNITY SECTORS AND REDUCE TREATMENT GAPS FOR INDIVIDUALS WITH OPIOID USE DISORDER BY STRENGTHENING PARTNERSHIPS WITH LAW ENFORCEMENT AND OTHER COMMUNITY SECTORS AND (4) INCREASE REFERRALS FOR NEEDED SERVICES BY BRINGING TOGETHER INTERDISCIPLINARY AND INTERAGENCY TEAMS TO BE REPRESENTED IN EACH COMMUNITY TASK FORCE.ADDITIONALLY, LAKE REGION HEALTHCARE CORPORATION WORKED TO ESTABLISH AN OPIOID SAFETY PROGRAM LED BY THE OPIOID SAFETY STEERING COMMITTEE ESTABLISHED IN NOVEMBER 2019, ENGAGE AND EDUCATE PROVIDERS ON MINNESOTA AND CDC OPIOID PRESCRIBING GUIDELINES, ENCOURAGE THE USE OF THE CONTROLLED SUBSTANCE CARE PLAN FOR PATIENTS ON CHRONIC OPIOID THERAPY OR WITH CONCOMITANT USE OF BENZODIAZEPINES, AND COLLABORATE WITH COMMUNITY PARTNERS TO IDENTIFY AND IMPLEMENT POTENTIAL EFFECTIVE ENVIRONMENTAL STRATEGIES TO ADDRESS OPIOID ABUSE/MISUSE THROUGH THE OTTER TAIL COUNTY OPIOID ABUSE PREVENTION TASK FORCE. ANOTHER STRATEGY OF LAKE REGION HEALTHCARE IN FISCAL YEAR 2020 WAS TO EXPAND ACCESS TO NALOXONE THROUGH EDUCATING PROVIDERS ON RECOMMENDATIONS REGARDING WHEN TO PRESCRIBE OR CO-PRESCRIBE NALOXONE AND HOST COMMUNITY NARCAN TRAINING. RESOURCES FOR THESE PROGRAMS WERE DIVERTED TO RESPOND TO THE COVID-19 PANDEMIC AND WE WERE NOT ABLE TO PREPARE AND PRESENT PROVIDER EDUCATION ON NALOXONE PRESCRIBING GUIDELINES. WE ARE CURRENTLY WORKING WITH OUR PHARMACY DEPARTMENT TO DEVELOP EDUCATION MATERIALS TO BE SHARED WITH ALL THE PROVIDERS AS PART OF THEIR ANN8UAL EDUCATION IN 2021. SIMILARLY, WE WERE NOT ABLE TO HOST COMMUNITY TRAININGS ON NARCAN AND OPIOID AWARENESS. DEPENDING ON THE COVID SITUATION IN OUR COMMUNITY, WE HOPE TO BE ABLE TO WORK WITH COMMUNITY PARTNERS AND FACILITATE COMMUNITY EDUCATION SESSIONS IN CALENDAR YEAR 2021.RESOURCE NAVIGATION - IN ALL FIVE FOCUS GROUP SESSIONS WE FACILITATED, THE AVAILABILITY OF A VARIETY OF HEALTH CARE SERVICES, COMMUNITY-BASED RESOURCES AND SOCIAL SERVICES WAS HIGHLIGHTED AS AN ASSET IN THE COMMUNITY. HOWEVER, MOST COMMUNITY MEMBERS ARE NOT AWARE OF THE RESOURCES AVAILABLE OR DO NOT KNOW HOW TO ACCESS THEM. THIS LIMITED AWARENESS OF SERVICES AND RESOURCES MAY LEAD TO COMMUNITY MEMBERS NOT SEEKING NEEDED SERVICES, IMPACTING HEALTH AND LEADING TO POORER HEALTH OUTCOMES AND QUALITY OF LIFE.ONE OF THE MAIN STRATEGIES TO STRENGTHEN RESOURCE NAVIGATION IS TO OPTIMIZE ACCESS TO HEALTH CARE THROUGH ENHANCING AWARENESS OF COMMUNITY RESOURCES AND HEALTHCARE/SUPPORT SERVICES. IN FISCAL YEAR 2020, WE PLANNED TO DO THIS THROUGH PILOTING A MONTHLY RESOURCE SERIES, PILOTING A FLOAT SOCIAL WORKER PROGRAM AT THE CLINIC, DEVELOPING A COMMUNITY RESOURCE LINK, AND CONSIDERING SCREENING PATIENTS FOR SOCIAL NEEDS. IN ORDER TO MEET THE SOCIAL WORKER NEEDS OF THE WHOLE ORGANIZATION, THE FLOAT SOCIAL WORK PROGRAM WAS ESTABLISHED IN OCTOBER 2019. DUE TO THE COVID-19 PANDEMIC, SOCIAL GATHERING RESTRICTIONS WERE PUT IN PLACE AND RESOURCES WERE REALLOCATED TO FOCUS ON PLANNING, PREPARING AND RESPONDING TO THE PANDEMIC. THEREFORE, WE WERE NOT ABLE TO COORDINATE THE RESOURCE SERIES IN THE PAST YEAR AS WE HAD HOPED. HOWEVER, DURING THIS TIME OF CRISIS, OUR COMMUNITY PARTNERS CONTINUED TO WORK ALONGSIDE EACH OTHER, CONNECTING AND COLLABORATING TO EDUCATE AND INFORM EACH OTHER ABOUT AVAILABLE COMMUNITY RESOURCES AS WELL AS COVID-SPECIFIC RESOURCES AND INFORMATION.CHRONIC DISEASES - CHRONIC DISEASES SUCH AS HEART DISEASE, CANCER, DIABETES AND OBESITY, ARE AMONG THEMOST COMMON, COSTLY AND PREVENTABLE ILLNESSES IN OUR SERVICE AREA AND ACROSS THE COUNTRY. CANCER AND HEART DISEASE ARE THE TOP TWO CAUSES OF DEATH IN OTTER TAIL COUNTY. THE MOST PREVALENT CANCER DIAGNOSIS IN THE COUNTY ARE LUNG AND COLORECTAL CANCERS WHILE BREAST CANCER IS THE MOST COMMON CANCER AMONG WOMEN IN OUR COMMUNITY. OBESITY WHICH IS NOW RECOGNIZED AS A CHRONIC DISEASE ALSO EXACERBATES MANY OTHER CHRONIC DISEASES, SUCH AS CARDIOVASCULAR DISEASE AND DIABETES. ACCORDING TO THE PARTNERSHIP4HEALTH SURVEY CONDUCTED IN 2018, CLOSE TO 40% OF OTTER TAIL COUNTY ADULTS ARE CONSIDERED TO BE OBESE WHILE 72.5% ARE EITHER OVERWEIGHT OR OBESE.TO ENCOURAGE HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN THE SERVICE AREA, LRH WORKED TO CREATE A HEALTHY ENVIRONMENT BY CONTINUING TO LEAD THE ANNUAL COMMUNITY HEALTH EXPO, SUPPORT LIVE WELL FERGUS FALLS AND THEIR INITIATIVES, EXPAND SHOP WITH THE DOC PROGRAM TO IMPROVE ACCESS TO HEALTHY FOOD CHOICES, ESTABLISH WALK WITH THE DOC PROGRAM TO INCREASE ACCESS TO PHYSICAL ACTIVITY OPPORTUNITIES, AND ADVOCATE FOR LOCAL BUSINESSES TO ADOPT WORKSITE WELLNESS INITIATIVES. DUE TO COVID-19, THE HEALTH EXPO WAS CANCELLED, AND THE SHOP WITH THE DOC AND WALK WITH THE DOC PROGRAMS WERE EXTREMELY LIMITED. HOWEVER, LAKE REGION HEALTHCARE ALONG WITH PARTNERSHIP4HEALTH AND OTHER MEMBERS OF LIVE WELL FERGUS FALLS WERE STILL ABLE TO WORK TO PROMOTE WORKSITE WELLNESS TO OTHER BUSINESSES IN THE COMMUNITY.IN ADDITION TO CREATING A HEALTHY ENVIRONMENT THROUGH COMMUNITY PROGRAMS, LRH WORKED TO IMPROVE ACCESS TO QUALITY PREVENTIVE SERVICES, THROUGH OFFERING I CAN PREVENT DIABETES CLASSES FOR FREE, GROWING THE LIFESTYLE MEDICINE PROGRAM, UTILIZING PRE-VISIT PLANNING FOR CANCER SCREENING REMINDERS, SENDING OUT TARGETED MAILINGS TO EDUCATE PARENTS AND PROMOTE HPV VACCINATION, AND SENDING OUT REMINDERS TO IMPROVE COMPLETION OF HPV SERIES. DUE TO LIMITATIONS STEMMING FROM THE COVID-19 PANDEMIC, MOST OF THESE PROGRAMS WERE CUT SHORT OR UNABLE TO GET GOING. WE WILL FURTHER EVALUATE THE PROGRAMS AND PERFORMANCE METRICS IN 2021 FOR FUTURE UPDATE.MORE DETAIL ON THE IDENTIFIED SIGNIFICANT HEALTH NEEDS AS WELL AS THE STRATEGIES AND ACTIVITIES DEVELOPED TO ADDRESS THEM CAN BE FOUND ON LAKE REGION HEALTHCARE'S WEBSITE AT HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH/.
LAKE REGION HEALTHCARE CORPORATION	PART V, SECTION B, LINE 24: THE FAP POLICY DOES NOT APPLY TO ELECTIVE SERVICES; THEREFORE, FAP ELIGIBLE INDIVIDUALS WERE CHARGED THE GROSS AMOUNT FOR ALL ELECTIVE SERVICES.

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7:	THE COST METHODOLOGY USED TO DETERMINE THE AMOUNTS IN LINE 7A-7D AND 7G IS THE ADJUSTED MEDICARE COST TO CHARGE RATIO ON THE 2019 COST REPORT. THE COST METHODOLOGY USED TO DETERMINE THE AMOUNTS IN LINE 7E, 7F, AND 7I ARE THE ACTUAL COSTS INCURRED AND RECORDED IN THE GENERAL LEDGER AND FINANCIAL STATEMENTS.
PART II, COMMUNITY BUILDING ACTIVITIES:	IN THE PAST YEAR, LRHC HAS PARTICIPATED IN A COMMUNITY GROUP FOCUSED ON DEVELOPING A COMMUNITY VISION AND ECONOMIC DEVELOPMENT. LRHC ALSO ALLOWED COMMUNITY GROUPS TO USE MEETING ROOMS FREE OF CHARGE TO ASSIST IN THEIR MISSIONS, ALONG WITH VARIOUS CASH DONATIONS GIVEN TO COMMUNITY ORGANIZATIONS.
PART III, LINE 2:	BAD DEBT EXPENSE ON LINE 2 IS REPORTED AT CHARGES AS PRESENTED ON THE FINANCIAL STATEMENTS.
PART III, LINE 4:	THE FOOTNOTE TO THE FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS LOCATED IN FOOTNOTE 1 ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE COSTING METHODOLOGY USED TO DETERMINE THE RELATED COSTS IS AN ADJUSTED MEDICARE COST TO CHARGE RATIO BASED ON THE 2019 COST REPORT.
PART III, LINE 9B:	THE COLLECTION POLICY STATES THAT CERTAIN INDIVIDUALS WITH VERY LIMITED MEANS MAY NOT BE ABLE TO MEET THE ACCEPTABLE PAYMENT GUIDELINES. WHEN THIS OCCURS, THE COLLECTION STAFF WILL EXHAUST EVERY CONSIDERATION TO RESOLVE THE ACCOUNTS, SUCH AS APPLICATIONS FROM MEDICAL AND GENERAL ASSISTANCE AND THE HOSPITAL CHARITY CARE PROGRAM. APPLICATIONS FOR CHARITY CARE ARE PROVIDED UPON REQUEST OR WHEN A PATIENT DEMONSTRATES THE NEED FOR THE CHARITY CARE PROGRAM ASSISTANCE.
PART VI, LINE 2:	ONE OF LAKE REGION HEALTHCARE'S GUIDING PRINCIPLES IS TO PROVIDE A HEALTHCARE SYSTEM THAT IS RESPECTFUL AND RESPONSIVE TO THEIR CUSTOMERS' NEEDS. IT IS ASSESSED ON A CONTINUAL BASIS. PERIODICALLY, LAKE REGION HEALTHCARE WORKS WITH OTTERTAIL COUNTY DEPARTMENT OF HEALTH TO PERFORM A FORMAL NEEDS ASSESSMENT OF THE COMMUNITY IT SERVES.
PART VI, LINE 3:	FOR THE UNINSURED AND SELF-PAY DISCOUNT, OUTPATIENT OR CLINIC SERVICES PATIENTS ARE SENT A LETTER AFTER ESTABLISHING THEIR FINANCIAL STATUS AS SELF PAY. THE LETTER INFORMS THEM THAT THERE IS A DISCOUNT PROGRAM THAT MAY BE AVAILABLE TO THEM IF THEY ARE WITHOUT INSURANCE. LAKE REGION HEALTHCARE FOLLOWS UP WITH A PHONE CALL TO SEE IF THEY RECEIVED THE LETTER AND DISCUSS THE PATIENTS' OPTIONS. ONCE IN THE COLLECTION PROCESS, PATIENTS WILL BE ASSESSED AS TO WHETHER OR NOT THEY WOULD BE ELIGIBLE FOR THE UNINSURED/SELF-PAY DISCOUNT. INPATIENTS ARE VISITED BY A PATIENT FINANCIAL SERVICES STAFF MEMBER TO EXPLAIN THE UNINSURED/SELF PAY DISCOUNT AN DIF ELIGIBLE, GIVEN AN APPLICATION FOR THE COMMUNITY CARE PROGRAM. FINANCIAL SERVICES PAMPHLETS EXPLAIN BOTH PROGRAMS AND ARE DISPERSED AROUND THE FACILITY. PROGRAM INFORMATION CAN ALSO BE ACCESSED ON LAKE REGION HEALTHCARE'S WEBSITE. EMPLOYEES AMONGST THE PATIENT DEPARTMENTS WORK WITH THE BUSINESS OFFICE TO BE SURE THAT EVERYONE WHO MAY BE ELIGIBLE RECEIVES THE APPROPRIATE INFORMATION. THE COLLECTION AGENCIES THAT ARE CONTRACTED WITH LAKE REGION HEALTHCARE ARE ALSO AWARE AND OFFER EITHER PROGRAM IF APPROPRIATE.
PART VI, LINE 4:	LAKE REGION HEALTHCARE PROVIDES PRIMARY AND SECONDARY HEALTHCARE SERVICES IN A RURAL AREA OF WEST CENTRAL MINNESOTA WITH A POPULATION OF APPROXIMATELY 100,000 PEOPLE. THE AVERAGE AGE OF THE POPULATION IS OLDER THAN BOTH THE STATE AND NATIONAL AVERAGES, WHICH LEADS TO A HIGHER THAN NORMAL PERCENTAGE OF OLDER PATIENTS WHOM THE HOSPITAL SERVES. APPROXIMATELY TWO-THIRDS OF THE PATIENT DAYS AT LAKE REGION HEALTHCARE ARE USED BY MEDICARE-AGED PATIENTS.
PART VI, LINE 5:	THE MOST TANGIBLE WAY THAT LAKE REGION HEALTHCARE PROVIDES COMMUNITY BENEFITS IS THROUGH COMMUNITY PROGRAMS AND SERVICES. IT PROVIDES THESE SERVICES AS A RESPONSIBLE MEMBER OF THE COMMUNITY. EDUCATIONAL PROGRAMS, HEALTHCARE SCREENINGS, SUPPORT GROUPS, AND OTHER COMMUNITY SERVICES ARE PROVIDED BY LAKE REGION HEALTHCARE TO IMPROVE THE HEALTHCARE AND QUALITY OF LIFE FOR THE PEOPLE IN THE COMMUNITY. THE MAJORITY OF THE 15 VOTING MEMBERS OF THE BOARD IS COMPRISED OF PERSONS WHO RESIDE WITHIN THIS SERVICE AREA. THE BOARD CONSISTS OF HOMEMAKERS, FARMERS, AND BUSINESS OWNER. LAKE REGION HEALTHCARE ALSO HAS AN OPEN MEDICAL STAFF AVAILABLE FOR ALL QUALIFIED PHYSICIANS. LAKE REGION HEALTHCARE BUDGETS FOR PROGRAMS WHICH ENCOURAGE INDIVIDUALS TO PRACTICE HEALTHCARE LIFESTYLES, AS WELL AS PROVIDES SUPPORT PROGRAMS WHICH BENEFIT THE ECONOMIES AND COMMUNITIES OF THEIR SERVICE AREA.
PART VI, LINE 6:	LAKE REGION HEALTHCARE FOUNDATION RECEIVES DONATIONS, MEMORIALS, PLEDGES, AND LEADS FUNDRAISING EVENTS. THE FUNDS RECEIVED ARE GRANTED TO LAKE REGION HEALTHCARE AND COMMUNITY ORGANIZATIONS TO SUPPORT PROVIDING QUALITY HEALTHCARE IN THE COMMUNITIES IN OUR SERVICE AREA.

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
LAKE REGION HEALTHCARE CORPORATION

Employer identification number
41-0730602

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) FERGUS FALLS 544 EDUCATION FOUNDATION 518 FRIBERG AVENUE FERGUS FALLS,MN56537	41-1978590	501(C)(3)	5,200	N/A	N/A	COMMUNITY BENEFIT
(2) FERGUS FALLS HOCKEY ASSOCIATION PO BOX 691 FERGUS FALLS,MN56538	23-7097408	501(C)(3)	29,000	N/A	N/A	COMMUNITY BENEFIT
(3) FERGUS FALLS PUBLIC LIBRARY 205 EAST HAMPDEN AVENUE FERGUS FALLS,MN56537		GOVERNMENTAL	20,000	N/A	N/A	COMMUNITY BENEFIT
(4) GREATER FERGUS FALLS CORPORATION 403 SOUTH UNION AVENUE SUITE 10 FERGUS FALLS,MN56537	83-1284758	501(C)(3)	15,000	N/A	N/A	COMMUNITY BENEFIT
(5) OTTER COVE CHILDREN'S MUSEUM 105 WEST LINCOLN AVENUE FERGUS FALLS,MN56538	83-3891315	501(C)(3)	25,000	N/A	N/A	COMMUNITY BENEFIT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation

Schedule I (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Yes

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KYLE RICHARDS CEO (THRU DEC 2019)	(i) (ii)	388,500 ------------- 0	0 ------------- 0	12,249 ------------- 0	46,123 ------------- 0	13,421 ------------- 0	460,293 ------------- 0	0 ------------- 0
2KENT MATTSON CEO	(i) (ii)	359,820 ------------- 0	0 ------------- 0	0 ------------- 0	19,500 ------------- 0	14,014 ------------- 0	393,334 ------------- 0	0 ------------- 0
3FRITZ KARSNIA ANESTHESIA DIRECTOR	(i) (ii)	303,453 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	11,454 ------------- 0	314,907 ------------- 0	0 ------------- 0
4JONATHAN ANDERSON CRNA	(i) (ii)	253,116 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	11,076 ------------- 0	264,192 ------------- 0	0 ------------- 0
5JEFFERY OLSON CRNA	(i) (ii)	252,994 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	11,076 ------------- 0	264,070 ------------- 0	0 ------------- 0
6JOY LINDGREN CMO (THRU JAN 2020)	(i) (ii)	262,551 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	907 ------------- 0	263,458 ------------- 0	0 ------------- 0
7TYLER SCOTT CRNA	(i) (ii)	259,286 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	539 ------------- 0	259,825 ------------- 0	0 ------------- 0
8LUCIA ANDERSON CNO/DIRECTOR OF SURGICAL SVCS	(i) (ii)	215,086 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	13,053 ------------- 0	228,139 ------------- 0	0 ------------- 0
9DANIELLE LESMEISTER PRAIRIE RIDGE CEO	(i) (ii)	150,674 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	11,902 ------------- 0	162,576 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

PART I, LINE 6

LRHC HAS IMPLEMENTED AN INCENTIVE COMPENSATION PROGRAM FOR CERTAIN EXECUTIVE LEADERSHIP POSITIONS WITHIN THE ORGANIZATION. CERTAIN MEASURES AND GOALS NEED TO BE MET IN ORDER FOR THE COMPENSATION TO BE PAID OUT IN WHOLE, SUCH AS MEETING FINANCIAL PERFORMANCE EXPECTATIONS AND QUALITY METRICS AND SUCCESSFUL IMPLEMENTATION OF STRATEGIC GOALS. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS PERFORMANCE ANNUALLY AND DETERMINES ANY AMOUNTS OF COMPENSATION THAT IS AWARDED.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 1	THERE IS AN EXECUTIVE COMMITTEE LIMITED TO SEVEN TRUSTEES, AND THESE TRUSTEES SHALL BE: (1) THE PRESIDENT (2) THE VICE PRESIDETN (3) THE SECRETARY (4) THE TREASURER (5) THE PAST PRESIDENT AND (6 AND 7) THE BOARD WILL DESIGNATE TWO BOARD MEMBERS AT LARGE TO SERVE ON THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL MEET AT LEAST FOUR TIMES EACH YEAR, ONCE IN EACH CALENDAR QUARTER. ITS MEETINGS MAY BE JOINT MEETINGS WITH THE BOARD OF TRUSTEES. UNLESS ITS AUTHORITY IS EXPRESSLY LIMITED BY THE BOARD, THE EXECUTIVE COMMITTEE SHALL EXERCIST THE FULL POWER OF THE BOARD ON THE BASIS OF BYLAW PROVISIONS AND WITHOUT SPECIFIC DELEGATION OF SUCH AUTHORITY BY THE BOARD, BUT ONLY IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 2	JOHN ERICKSON, MATTHEW MOUSER, ERIN PETERSON, AND WADE SWENSON ARE AFFILIATED WITH COMPANIES THAT HAVE A BUSINESS RELATIONSHIP WITH LAKE REGION HEALTHCARE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 3	LAKE REGION HEALTHCARE CORPORATION HIRED WITT/KIEFFER, INC. TO PROVIDE AN INTERIM CHIEF FINANCIAL OFFICER (CFO). THE INTERIM CFO WAS RESPONSIBLE FOR OVERSEEING THE FINANCIAL OPERATIONS OF THE ORGANIZATION AND RELATED ORGANIZATIONS. WITT/KIEFFER, INC. EMPLOYED CAMIE PATTERSON TO PROVIDE THESE SERVICES, AND WITT/KIEFFER, INC. RECEIVED $466,934 IN COMPENSATION FOR THE SERVICES PROVIDED BY CAMIE. CAMIE PATTERSON WAS HIRED TO BE THE FULL-TIME CFO FOR LAKE REGION HELATHCARE CORPORATION AND ALL RELATED ORGANIZATIONS IN APRIL OF 2020.
FORM 990, PART VI, SECTION B, LINE 11B	COPIES OF THE COMPLETED FORM 990, WITH SUPPORTING SCHEDULES AND FOOTNOTES, WERE DISTRIBUTED TO ALL LRHC BOARD MEMBERS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE DETAILED AND CONSCIENTIOUS REVIEW BY ALL BOARD MEMBERS AND OPPORTUNITY FOR FEEDBACK AND CORRECTION. ALL QUESTIONS, CONCERNS, OR OTHER FEEDBACK FROM BOARD MEMBERS WERE DIRECTED TO THE LRHC CHIEF FINANCIAL OFFICER AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE, SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED CONSCIENTIOUS REVIEW BY ALL EXECUTIVE OR FINANCE COMMITTEE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST DISCLOSURES ARE COLLECTED FROM ALL INTERESTED PERSONS, OFFICERS, AND TRUSTEES ANNUALLY ASSESS WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST ACCORDING TO THE CONFLICTS OF INTEREST POLICY. IT IS CONSISTENTLY MONITORED DURING THE YEAR TO BE SURE THAT THE WRITTEN POLICY IS BEING FOLLOWED.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION FOR THE OFFICERS OF LAKE REGION HEALTHCARE IS REVIEWED ANNUALLY, OUTSIDE INDEPENDENT COMPENSATION CONSULTANTS ARE ENGAGED FOR FAIR MARKET ASSESSMENTS, AS WELL AS MHA SALARY SURVEYS. COMPENSATION IS PRESENTED FOR APPROVAL TO THE EXECUTIVE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19	LAKE REGION HEALTHCARE'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY REQUEST.
FORM 990, PART VII, SECTION A:	CAMIE PATTERSON, CFO, WAS CONTRACTED AS INTERIM CFO FOR LAKE REGION HEALTHCARE CORPORATION AND RELATED ORGANIZATIONS THROUGH CALENDAR YEAR 2019, SO NO WAGES WERE REPORTED ON PART VII OF THE FORM 990. CAMIE WAS HIRED AS THE PERMANENT CFO FOR LAKE REGION HEALTHCARE CORPORATION AND ALL RELATED ORGANIZATIONS IN APRIL 2020.
FORM 990, PART IX, LINE 11G	OUTSIDE CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,122,088. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,122,088. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 30,397,957. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,397,957. COLLECTION FEES: PROGRAM SERVICE EXPENSES 234,457. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 234,457. OUTSIDE LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 206,451. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 206,451. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,441,473. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,441,473. STUDENT PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 211,632. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 211,632.
FORM 990, PART XII, LINE 2C:	THE PROCESS FOR SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART XII, LINE 3C:	THE REQUIRED AUDIT RESULTING FROM THE FEDERAL AWARD WAS NOT REQUIRED UNTIL AFTER FISCAL YEAR-END. THE ORGANIZATION INTENDS TO UNDERGO THE REQUIRED AUDIT IN THE SUBSEQUENT YEAR.
FORM 990, HEADER, LINE C:	LAKE REGION HEATLHCARE ALSO DOES BUSINESS AS: LAKE REGION HEALTHCARE CLINIC SERVICES - ASHBY CLINIC, LAKE REGION HEALTHCARE CLINIC SERVICES - BATTLE LAKE, LAKE REGION HEALTHCARE CLINIC SERVICES - FERGUS FALLS, LAKE REGION HOSPITAL, AND LAKE REGION HEALTHCARE - WALK-IN CLINIC.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LAKE REGION HEALTHCARE CORPORATION

Employer identification number

41-0730602

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) LAKE REGION MEDICAL BUILDING 712 SOUTH CASCADE STREET FERGUS FALLS,MN56538 47-2843862	PROVIDE REAL AND PERSONAL PROPERTY FOR LAKE REGION HEALTHCARE CORPORATION	MN	183,000	25,398,368	LAKE REGION HEALTHCARE CORPORATION

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)LAKE REGION HEALTHCARE FOUNDATION 712 SOUTH CASCADE STREET FERGUS FALLS,MN56538 41-1677288	FUNDRAISING	MN	501(C)(3)	LINE 12A, I	LAKE REGION HEALTHCARE CORPORATION		No
(2)LRHC LONG-TERM CARE FACILITIES INC 712 SOUTH CASCADE STREET FERGUS FALLS,MN56538 41-1817549	ASSISTED LIVING	MN	501(C)(3)	LINE 10	LAKE REGION HEALTHCARE CORPORATION		No
(3)PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES 1411 HIGHWAY 79 EAST ELBOW LAKE,MN56531 41-1763968	HEALTHCARE SERVICES	MN	501(C)(3)	LINE 3	LAKE REGION HEALTHCARE CORPORATION		No
(4)PRAIRIE RIDGE FOUNDATION 1411 HIGHWAY 79 EAST ELBOW LAKE,MN56531 45-5092280	FUNDRAISING	MN	501(C)(3)	LINE 7	PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) WEST CENTRAL LINEN SERVICES 712 SOUTH CASCADE STREET FERGUS FALLS,MN56538 41-1411129	LAUNDRY & LINEN	MN	N/A	UNRELATED		244,123		No			No
(2) LRH RAD ONC SERVICES 712 SOUTH CASCADE STREET FERGUS FALLS,MN56538 27-1322270	RADIATION & ONCOLOGY SERVICES	MN	LAKE REGION HEALTHCARE	RELATED		1,908,877		No		Yes
(3) LAKE REGION HOME MEDICAL SUPPLY 712 SOUTH CASCADE STREET FERGUS FALLS,MN56538 46-4182501	MEDICAL EQUIPMENT SALES	MN	N/A	RELATED		126,969		No		Yes

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) LRH RAD ONC SERVICES	Q	458,503	PATIENT BILLING SERVICES
(2) WEST CENTRAL LINEN SERVICES	M	198,931	LAUNDRY SERVICES
(3) LAKE REGION HEALTHCARE FOUNDATION	Q	78,956	OPERATING EXPENSES
(4) LAKE REGION HOME MEDICAL SUPPLY	O	401,459	EMPLOYEE WAGES
(5) PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES	Q	4,238,559	OPERATING EXPENSES
(6) LRHC LONG-TERM CARE FACILITIES INC	Q	695,336	OPERATING EXPENSES

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE PURPOSE OF LAKE REGION HEALTHCARE IS TO PROVIDE QUALITY HEALTH CARE SERVICE IN A CARING MANNER TO EACH INDIVIDUAL WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	998
6	Total number of volunteers (estimate if necessary) .............	6	73
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	209,840
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	233,862	9,364,831
9	Program service revenue (Part VIII, line 2g) .........	127,561,413	121,227,432
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	5,201,140	1,357,528
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,459,137	12,379,665
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	135,455,552	144,329,456
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	126,724
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	51,623,423	50,632,434
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	83,952,882	82,764,775
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	135,576,305	133,523,933
19	Revenue less expenses. Subtract line 18 from line 12.......	-120,753	10,805,523
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	140,956,595	168,669,550
21	Total liabilities (Part X, line 26).............	50,568,414	64,305,293
22	Net assets or fund balances. Subtract line 21 from line 20.....	90,388,181	104,364,257

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 86,305,230 including grants of $ 126,724 ) (Revenue $ 92,936,866 )
	LAKE REGION HEALTHCARE CORPORATION IS A NOT-FOR-PROFIT PROVIDER OF HEALTH CARE SERVICES OPERATING A 108-BED HOSPITAL COMPRISED OF A 94-BED ACUTE HOSPITAL, A 14-BED PSYCHIATRIC UNIT, AND MULTIPLE CLINIC SITES. OUT PURPOSE IS TO MEET THE HEALTH CARE NEEDS OF THE PEOPLE IN WEST CENTRAL MINNESOTA. OUR VISION IS TO BE MINNESOTA'S PREEMINENT REGIONAL HEALTH CARE PARTNER. OUR CORE VALUES INCLUDE INTEGRITY, TEAMWORK, COMPASSION, AND EXCELLENCE. LAKE REGION HEALTHCARE CORPORATION IS A PROVIDER OF QUALITY HEALTH CARE SERVICES, AS NOTED BY OUR ACCREDITATION BY THE JOINT COMMISSION. SERVICES THAT LAKE REGION HEALTHCARE PROVIDES INCLUDE MEDICAL/SURGICAL, PEDS, OB GYN, ICCU, RADIOLOGY/INTERVENTIONAL RADIOLOGY, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH THERAPY, RESPIRATORY CARE, SOCIAL WORK, SURGERY, ONCOLOGY, BIRTHING SUITES, CARDIAC REHAB/ECP, EMERGENCY SERVICES, COMMUNITY WELLNESS, AND LABORATORY.

4b	(Code: ) (Expenses $ 26,144,881 including grants of $ 0 ) (Revenue $ 28,153,836 )
	LAKE REGION HEALTHCARE OFFERS CLINICAL SERVICES IN FOUR COMMUNITIES AND A WALK-IN CLINIC. SPECIALTIES OFFERED THROUGH CLINIC SERVICES INCLUDE CARDIOLOGY, OB GYN, PEDIATRICS, OPHTHALMOLOGY, FAMILY MEDICINE, INTERNAL MEDICINE, UROLOGY, DERMATOLOGY, ENT, ALLERGY, AUDIOLOGY, PODIATRY, PULMONOLOGY, SPORTS MEDICINE, SURGERY, AND ORTHOPEDICS.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses112,450,111

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) CARRIE BRIMHALL........................................................................ VICE CHAIR	5.00 .......................0.00	X	X	0	0	0
(19) LAUREL NELSON........................................................................ TREASURER	5.00 .......................0.00	X	X	0	0	0
(20) SCOTT BAUER........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0
(21) DEB FERGUSON........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0
(22) CHUCK MCFARLANE........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0
(23) MATTHEW MOUSER MD........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0
(24) JERRY NESS........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0
(25) ERIN PETERSON MD........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0
(26) STEPHEN RUFER........................................................................ PAST CHAIR	4.00 .......................0.00	X		0	0	0
(27) NAOMI SCHMID MD........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0
(28) WADE SWENSON MD........................................................................ TRUSTEE	4.00 .......................0.00	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,845,097	1,980	188,378

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	121,235
e	Government grants (contributions)		1e	9,110,225

f	All other contributions, gifts, grants, and similar amounts not included above		1f	133,371

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		9,364,831

		Business Code
2a	PATIENT CARE SERVICES	623000	121,227,432	121,090,702	136,730
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		121,227,432

3 Investment income (including dividends, interest, and othersimilar amounts) ......			973,061			973,061
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,041,971	6a
b	Less: rental expenses		47,743	6b
c	Rental income or (loss)		994,228	6c
d	Net rental income or (loss).......			994,228			994,228
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	401,339	2,608,946	7a
b	Less: cost or other basis and sales expenses	64,896	2,560,922	7b
c	Gain or (loss)	336,443	48,024	7c
d	Net gain or (loss).........			384,467			384,467
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OUTSIDE SERVICE REVENU		623000	6,054,049			6,054,049
b	RECOVERY OF CERNER IMP		900099	5,000,000			5,000,000
c	OPTICAL SALES		446199	690,560		73,110	617,450
d	All other revenue ....			-359,172			-359,172
e	Total. Add lines 11a–11d ......			11,385,437
12	Total revenue. See instructions.....			144,329,456	121,090,702	209,840	13,664,083

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	126,724	126,724
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,210,267		1,210,267
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	40,587,660	27,796,728	12,790,932
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	593,950	400,261	193,689
9	Other employee benefits .......	5,349,463	3,557,929	1,791,534
10	Payroll taxes ...........	2,891,094	1,948,297	942,797
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	115,226		115,226
c	Accounting ...........	132,662		132,662
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	34,614,058	34,614,058
12	Advertising and promotion ....	964,434	649,928	314,506
13	Office expenses .......	416,939		416,939
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,798,915	2,450,903	348,012
17	Travel ............	111,336	33,504	77,832
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,228,229	833,580	394,649
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	5,019,321	3,604,377	1,414,944
23	Insurance ...	703,224	703,224
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	SUPPLIES	23,203,828	23,203,828
b	REPAIRS AND MAINTENANCE	5,407,895	4,668,006	739,889
c	BAD DEBTS	4,268,025	4,268,025
d	MN HEALTH SURCHARGE	2,252,967	2,252,967
e	All other expenses	1,527,716	1,337,772	189,944
25	Total functional expenses. Add lines 1 through 24e	133,523,933	112,450,111	21,073,822	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			7,337,818	1	29,074,060
2	Savings and temporary cash investments .........			92,628	2	223,712
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			24,264,142	4	22,281,448
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			8,994,567	7	10,009,670
8	Inventories for sale or use ............			2,234,324	8	2,464,656
9	Prepaid expenses and deferred charges ......			1,520,720	9	1,311,932
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	135,122,915
b	Less: accumulated depreciation	10b	76,426,397	60,266,694	10c	58,696,518
11	Investments—publicly traded securities .			34,374,432	11	30,936,254
12	Investments—other securities. See Part IV, line 11 .....			1,450,999	12	2,050,202
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			420,271	15	11,621,098
16	Total assets. Add lines 1 through 15 (must equal line 33)...			140,956,595	16	168,669,550

17	Accounts payable and accrued expenses .....	14,557,165	17	16,081,485
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	35,865,525	23	36,782,887
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	145,724	25	11,440,921
26	Total liabilities. Add lines 17 through 25..	50,568,414	26	64,305,293

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	0	29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	90,388,181	31	104,364,257
32	Total net assets or fund balances ...........	90,388,181	32	104,364,257
33	Total liabilities and net assets/fund balances ........	140,956,595	33	168,669,550