Ely-Bloomenson Community Hospital & Nursing Home in Ely, Minnesota (MN)

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Ely-Bloomenson Community Hospital & Nursing Home
Employer Identification Number (EIN)410808719
Name of OrganizationEly-Bloomenson Community Hospital & Nursing Home
Address328 W Conan St, Ely, MN 55731-1145
ActivitiesHospital
SubsectionCharitable Organization
Ruling Date04/1957
DeductibilityContributions are deductible
FoundationHospital or medical research organization
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period09/2013
Assets$10,000,000 to $49,999,999
Income$10,000,000 to $49,999,999
Filing Requirement990 (all other) or 990EZ return
Asset Amount$28,310,498
Amount of Income$17,312,171
Form 990 Revenue Amount$17,306,149
National Taxonomy of Exempt Entities (NTEE)Health - General and Rehabilitative: Hospital, General


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Amount of income in 2013: $17,312,171 (it was $24,566,189 in 2012)
Ely-Bloomenson Community Hospital & Nursing Home: 

 $17,312,171
Other organizations performing similar types of work: 

 $13,972,681

Assets in 2013: $28,310,498 (it was $28,253,494 in 2012)
This organization: 

 $28,310,498
Other organizations performing similar types of work: 

 $11,373,581

Expenses in 2013: $15,876,229
Ely-Bloomenson Community Hospital & Nursing Home: 

 $15,876,229
Other organizations performing similar types of work: 

 $14,578,904

Income to expenses ratio in 2013: 1.1
Ely-Bloomenson Community Hospital & Nursing Home: 

 1.1
Other organizations performing similar types of work: 

 1.1

Number of employees in 2013: 134
Ely-Bloomenson Community Hospital & Nursing Home: 

 134
Other organizations performing similar types of work: 

 196

Employees paid over $100,000 in 2013: 12.7%
This organization: 

 12.7%
Other organizations performing similar types of work: 

 0.0%

Grants share in income in 2013: 0.0%
Ely-Bloomenson Community Hospital & Nursing Home: 

 0.0%
Other organizations performing similar types of work: 

 0.2%

Financial snapshot ($)

Revenue for 2013

Assets at the end of 2013

Functional expenses for 2013

Checklist
20122013
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?YesYes
Is the organization required to complete Schedule B, Schedule of Contributors?YesYes
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?NoNo
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?NoYes
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?NoNo
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?NoNo
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?NoNo
Did the organization maintain collections of works of art, historical treasures, or other similar assets?NoNo
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?YesNo
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?YesYes
Did the organization report an amount for land, buildings, and equipment?YesYes
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?YesYes
Did the organization report an amount for investments-program related that is 5% or more of its total assets?NoNo
Did the organization report an amount for other assets that is 5% or more of its total assets?NoNo
Did the organization report an amount for other liabilities?NoYes
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?YesYes
Did the organization obtain separate, independent audited financial statements for the tax year?NoNo
Was the organization included in consolidated, independent audited financial statements for the tax year?YesYes
Is the organization a school described in section 170(b)(1)(A)(ii)?NoNo
Did the organization maintain an office, employees, or agents outside of the United States?NoNo
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?NoNo
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?NoNo
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?NoNo
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?NoNo
Did the organization report more than $15,000 total of fundraising event gross income and contributions?NoNo
Did the organization report more than $15,000 of gross income from gaming activities?NoNo
Did the organization operate one or more hospital facilities?YesYes
Did the organization attach a copy of its audited financial statements?YesYes
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?NoNo
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?NoNo
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?NoNo
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?NoNo
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?NoNo
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?NoNo
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?NoNo
Did the organization engage in an excess benefit transaction with a disqualified person during the year?NoNo
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?NoNo
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?NoNo
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?NoNo
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?NoNo
A family member of a current or former officer, director, trustee, or key employee?NoNo
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?NoNo
Did the organization receive more than $25,000 in non-cash contributions?NoNo
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?NoNo
Did the organization liquidate, terminate, or dissolve and cease operations?NoNo
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?NoNo
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?NoNo
Was the organization related to any tax-exempt or taxable entity?YesYes
Did the organization have a controlled entity within the meaning of section 512(b)(13)?NoNo
Did the organization make any transfers to an exempt non-charitable related organization?NoNo
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?NoNo
Statements Regarding Other IRS Filings and Tax Compliance
201120122013
The number reported in Box 3 of Form 10964140
The number of Forms W-2G00
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?YesYes
The number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return234134
Did the organization file all required federal employment tax returns?YesYes
Did the organization have unrelated business gross income of $1,000 or more during the year?YesYesYes
Has it filed a Form 990-T for this year?YesYes
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?NoNo
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?NoNo
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?NoNo
Did the organization file Form 8886-T?NoNo
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?NoNo
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?NoNo
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?NoNo
Did the organization notify the donor of the value of the goods or services provided?NoNo
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?NoNo
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?NoNo
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?NoNo
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?NoNo
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?NoNo
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?NoNo
Did the sponsoring organization make any taxable distributions under section 4966?NoNo
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?NoNo
Initiation fees and capital contributions$0$0$0
Gross receipts for public use of club facilities $0$0$0
Gross income from members or shareholders$0$0$0
Gross income from other sources$0$0$0
Is the organization filing Form 990 in lieu of Form 1041?NoNo
The amount of tax-exempt interest received or accrued during the year$0$0
Is the organization licensed to issue qualified health plans in more than one state?NoNo
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans$0$0
The amount of reserves on hand$0$0
Did the organization receive any payments for indoor tanning services during the tax year?NoNo
Has it filed a Form 720 to report these payments?NoNo
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
20122013
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization$405,046$417,869
Total reportable compensation from related organizations$0$0
Total estimated amount of other compensation from the organization and related organizations$61,785$65,289
Total number of individuals who received more than $100,000 of reportable compensation from the organization27
Total number of independent contractors who received more than $100,000 of compensation from the organization910
Statement of Revenue
201120122013
Total revenue$20,106,177$17,897,534$17,306,149
Contributions, Gifts, Grants and Other Similar Amounts$127,161$68,107$7,848
Program Service Revenue$18,967,300$16,846,617$16,193,660
621400$14,432,215$14,009,348
Pharmacies and Drug Stores $2,368,558$2,129,227
621400$30,143$36,394
621400$15,701$18,691
All other program service revenue$0$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)$470,910$515,363$684,788
Income from investment of tax-exempt bond proceeds$0$0$0
Royalties$0$0$0
Net rental income$44,102$41,871$40,427
Gross rents (Real / Personal)$50,960 / $0$47,653 / $0$46,449 / $0
Less: rental expenses (Real / Personal)$6,858 / $0$5,782 / $0$6,022 / $0
Rental income or (loss) (Real / Personal)$44,102 / $0$41,871 / $0$40,427 / $0
Net gain/loss from sales of assets other than inventory$78,068$132,895$158,917
Gross amount from sales of assets other than inventory (Securities / Other)$7,504,408 / $8,268$6,792,768 / $3,000$158,667 / $250
Less: cost or other basis and sales expenses (Securities / Other)$7,419,395 / $15,213$6,651,120 / $11,753$0 / $0
Gain or (loss) (Securities / Other)$85,013 / $-6,945$141,648 / $-8,753$158,667 / $250
Net income/loss from fundraising events$0$0$0
Net income/loss from gaming activities$0$0$0
Net income/loss from sales of inventory$0$0$0
Miscellaneous Revenue$418,636$292,681$220,509
621400$142,538$146,115
621400$122,990$74,394
All other revenue$0$0
Statement of Functional Expenses
201120122013
Total functional expenses$20,566,763$15,926,156$15,876,229
Grants and other assistance to domestic organizations and domestic governments$0$0
Grants and other assistance to domestic individuals$0$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals$0$0
Benefits paid to or for members$0$0
Compensation of current officers, directors, trustees, and key employees$340,190$354,572$429,410
Compensation not included above, to disqualified persons$0$0
Other salaries and wages$6,816,160$4,610,350$4,729,779
Pension plan accruals and contributions$111,377$120,462
Other employee benefits$681,148$855,282
Payroll taxes$530,128$360,056$372,681
Fees for services (non-employees)
Management$0$0
Legal$115,071$61,956
Accounting$77,392$76,802
Lobbying$0$0
Professional fundraising services$0$0$0
Investment management fees$0$0
Other$57,422$9,444
Advertising and promotion$0$0
Office expenses$178,061$158,555
Information technology$162,110$169,961
Royalties$0$0
Occupancy$0$0
Travel$9,351$8,259
Payments of travel or entertainment expenses for any federal, state, or local public officials$0$0
Conferences, conventions, and meetings$0$0
Interest$606,458$589,621
Payments to affiliates$0$0
Depreciation, depletion, and amortization$1,298,318$1,276,948
Insurance$57,951$42,012
Other expenses$4,739,496$4,444,426
Other expenses$1,234,884$1,190,335
Other expenses$657,210$721,493
Other expenses$405,473$409,311
Other expenses$209,456$209,492
Balance Sheet
201120122013
Total assets$26,797,034$28,253,494$28,310,498
Cash - non-interest-bearing$2,329,938$1,377,355
Savings and temporary cash investments$0$0
Pledges and grants receivable, net$0$0
Accounts receivable, net$2,254,979$2,496,867
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees$0$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations$0$0
Notes and loans receivable, net$0$0
Inventories for sale or use$558,924$478,657
Prepaid expenses and deferred charges$76,850$70,490
Land, buildings, and equipment: cost or other basis$11,780,584$11,099,838
Investments - publicly traded securities$8,116,070$10,031,064
Investments - other securities$2,652,329$2,511,834
Investments - program-related$0$0
Intangible assets$0$0
Other assets$483,820$244,393
Total liabilities$15,725,193$15,082,091$14,216,167
Accounts payable and accrued expenses$2,446,493$1,917,076
Grants payable$0$0
Deferred revenue$0$0
Tax-exempt bond liabilities$0$0$0
Escrow or custodial account liability$0$0
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons$0$0
Secured mortgages and notes payable to unrelated third parties$12,980,774$12,635,598$12,274,116
Unsecured notes and loans payable to unrelated third parties$0$0$0
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)$0$24,975
Total net assets or fund balances$11,071,841$13,171,403$14,094,331
Unrestricted net assets$13,171,403$14,094,331
Temporarily restricted net assets$0$0
Permanently restricted net assets$0$0
Capital stock or trust principal, or current funds$0$0
Paid-in or capital surplus, or land, building, or equipment fund$0$0
Retained earnings, endowment, accumulated income, or other funds$0$0$0
Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii)
Number of organizations supported0
Sum of amounts of support$0
Unrelated Trade or Business Income (for 2008)
IncomeExpensesNet
Total$1,727,181$0$172,718
Gross receipts or sales less returns and allowances$2,589,060$0$0
Cost of goods sold$24,163,421$0$0
Gross profit$1,727,181$0$172,718
Capital gain net income$0$0$0
Net gain$0$0$0
Capital loss deduction for trusts$0$0$0
Income (loss) from partnerships and S corporations$0$0$0
Rent income$0$0$0
Unrelated debt-financed income$0$0$0
Interest, annuities, royalties, and rents from controlled organizations$0$0$0
Investment income of a section 501(c)(7), (9), or (17) organization$0$0$0
Exploited exempt activity income$0$0$0
Advertising income$0$0$0
Other income$0$0$0
Deductions Not Taken Elsewhere (for 2008)
Total deductions$403,836
Compensation of officers, directors, and trustees$0
Salaries and wages$18,740
Repairs and maintenance$0
Bad debts$0
Interest$0
Taxes and licenses$0
Charitable contributions$0
Depreciation$0
Depletion$0
Contributions to deferred compensation plans$0
Employee benefit programs$26,986
Excess exempt expenses$0
Excess readership costs$0
Other deductions$358,110
Unrelated business taxable income$-231,118
Unrelated business taxable income before net operating loss deduction$-231,118
Net operating loss deduction$0
Unrelated business taxable income before specific deduction$-231,118
Specific deduction$1,000
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1Ucare Minnesota500 Stinson Blvd, Minneapolis, MN 55413-2615MN1989-04$2,693,144,806
2Hudson Hospital IncPO BOX 1309, Minneapolis, MN 55440-1309MN1954-10$51,156,083
3United Helpers Nursing Home Inc8101 State Highway 68, Ogdensburg, NY 13669-4403NY1970-06$15,273,370
4Ridgeview Clinics500 S Maple St, Waconia, MN 55387-1752MN1991-06$9,559,451
5United Memorial Medical Center127 North St, Batavia, NY 14020-1631NY1960-07$82,203,961
6Bert Fish Medical Center Inc401 Palmetto St, New Smyrna, FL 32168-7322FL1995-10$71,517,904
7Sweetwater Hospital Association304 Church St, Sweetwater, TN 37874-2823TN1976-03$58,739,879
8South Peninsula Hospital Inc4300 Bartlett St, Homer, AK 99603-7005AK1972-08$54,972,418
9Troy Community Hospital Incorporated275 Guthrie Dr, Troy, PA 16947-8115PA1954-03$50,585,986
10Wright State Physicians Inc725 University Blvd, Dayton, OH 45435-0001OH1992-08$43,886,596
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12Centracare Health System Of Melrose, Melrose Area Hospital525 Main St W, Melrose, MN 56352-1043MN1997-04$30,260,357
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16Lake View Memorial Hospital Incorporated325 11th Ave, Two Harbors, MN 55616-1300MN1960-06$15,061,548
17Northern Pines Medical Center5211 Highway 110, Aurora, MN 55705-1522MN1961-10$14,755,268
18Portico Healthnet2610 University Ave West, St Paul, MN 55114-2007MN1995-08$3,111,069
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Number of organizations performing similar types of work
Alaska2
Alabama4
Arkansas10
Arizona70
California20
Colorado2
Connecticut2
District of Columbia1
Delaware1
Florida12
Georgia9
Hawaii3
Iowa15
Idaho1
Illinois16
Indiana21
Kansas13
Kentucky18
Louisiana4
Massachusetts8
Maryland6
Maine8
Michigan28
Minnesota12
Missouri11
Mississippi3
Montana10
North Carolina11
North Dakota8
Nebraska8
New Hampshire3
New Jersey8
New Mexico1
Nevada2
New York20
Ohio24
Oklahoma13
Oregon3
Pennsylvania27
South Carolina6
South Dakota6
Tennessee19
Texas24
Utah1
Virginia12
Vermont3
Washington8
Wisconsin16
West Virginia9
Total542

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