CENTRACARE HEALTH FOUNDATION: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- CENTRACARE HEALTH FOUNDATION (EIN 41-1855173)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-15
- IRS object ID
- 202441369349309099
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-15T14:35:40-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 411334380 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLER WELLE HEISER & CO LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4170 THIELMAN LANE PO BOX 159 | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563020159 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411855173 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3202512700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HOLLY M GULDEN | PersonNm |
| Person Title | VICE PRESIDENT FOUNDATION | PersonTitleTxt |
| Phone | 3202512700 | PhoneNum |
| Signature | 2024-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | HOLLY | PersonFirstNm |
| Person Last | GULDEN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TRINA PEETERS CPA | PreparerPersonNm |
| PTIN | P01625727 | PTIN |
| Phone | 3202539505 | PhoneNum |
| Preparation | 2024-05-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | HOLLY M GULDEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,230,714 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTRACARE.COM/FOUNDATION | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR RELIGIOUS, EDUCATIONAL AND CHARITABLE PURPOSES, AS CONTEMPLATED AND PERMITTED BY SECTIONS 170(C)(2) AND 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986. WITHIN THE FRAMEWORK OF THE FOREGOING, THE PURPOSE FOR WHICH THE CORPORATION IS FORMED, AND THE BUSINESS AND THE OBJECTS TO BE CARRIED ON BY IT, IS TO PROVIDE A MEANS OF IMPROVING THE HEALTH OF THE COMMUNITIES SERVED BY CENTRACARE, PRINCIPALLY AS FOLLOWS: (A) ENGAGING IN ACTIVITIES TO PROMOTE THE GENERAL HEALTH OF ALL MEMBERS OF THE COMMUNITY AND IMPROVE THE DELIVERY OF HEALTH CARE SERVICES. (B) PROMOTING AND FURTHERING THE PROVISION OF HEALTH AND MEDICAL CARE SERVICES TO INDIVIDUALS WITH LIMITED OR NO FINANCIAL ABILITY TO PAY FOR SUCH SERVICES. (C) PROMOTING HEALTH EDUCATION. (D) PROMOTING MEDICAL AND ALLIED HEALTH EDUCATION. (E) SOLICITING GIFTS FROM PRIVATE AND PUBLIC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 150 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,794,222 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,981,208 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,770,071 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,705,480 | CYInvestmentIncomeAmt |
| PY Other Revenue | $321,595 | PYOtherRevenueAmt |
| CY Other Revenue | -$21,180 | CYOtherRevenueAmt |
| PY Total Revenue | $13,885,888 | PYTotalRevenueAmt |
| CY Total Revenue | $11,665,508 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,641,571 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,809,157 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,430,747 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,199,998 | PYOtherExpensesAmt |
| CY Other Expenses | $2,779,679 | CYOtherExpensesAmt |
| PY Total Expenses | $5,841,569 | PYTotalExpensesAmt |
| CY Total Expenses | $6,588,836 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,044,319 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,076,672 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $72,228,347 | TotalAssetsBOYAmt |
| Total Assets EOY | $80,467,755 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $574,044 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,285,424 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $71,654,303 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $78,182,331 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR RELIGIOUS, EDUCATIONAL AND CHARITABLE PURPOSES, AS CONTEMPLATED AND PERMITTED BY SECTIONS 170(C)(2) AND 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986. WITHIN THE FRAMEWORK OF THE FOREGOING, THE PURPOSE FOR WHICH THE CORPORATION IS FORMED, AND THE BUSINESS AND THE OBJECTS TO BE CARRIED ON BY IT, IS TO PROVIDE A MEANS OF IMPROVING THE HEALTH OF THE COMMUNITIES SERVED BY CENTRACARE, PRINCIPALLY AS FOLLOWS: (A) ENGAGING IN ACTIVITIES TO PROMOTE THE GENERAL HEALTH OF ALL MEMBERS OF THE COMMUNITY AND IMPROVE THE DELIVERY OF HEALTH CARE SERVICES. (B) PROMOTING AND FURTHERING THE PROVISION OF HEALTH AND MEDICAL CARE SERVICES TO INDIVIDUALS WITH LIMITED OR NO FINANCIAL ABILITY TO PAY FOR SUCH SERVICES. (C) PROMOTING HEALTH EDUCATION. (D) PROMOTING MEDICAL AND ALLIED HEALTH EDUCATION. (E) SOLICITING GIFTS FROM PRIVATE AND PUBLIC. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,145,502 | ExpenseAmt |
| Grant | $3,809,157 | GrantAmt |
| Desc | ACTIVITIES INCLUDED CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ACTIVITIES FOR THE BENEFIT OF THE COMMUNITIES SERVED BY THE ST. CLOUD HOSPITAL AND CENTRACARE. | Desc |
| Total Program Service Expenses | $4,145,502 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | Yes (1) | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | Yes (1) | NondeductibleContributionsInd |
| Nondeductible Contri Discl | Yes (1) | NondeductibleContriDisclInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | 0 | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLLY M GULDEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3202512700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| RICK BUTTE | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| DR EDWARD MARTIN-CHAFFEE MD | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $681,455 | $76,089 | 40.00 | ||||
| TAMARA CONGDON MD | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $333,265 | $46,168 | 40.00 | ||||
| MIKE STOEBE | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| BERNIE PERRYMAN | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JIM JOHNSON | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| TOM D ST HILAIRE | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| PETER SPANIOL | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JAN DINGMANN | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| BRAD KONKLER | ||||||||||
| VICE PRESIDENT, FOUNDATION | 40.00 | Yes (X) | $0 | $381,533 | $36,778 | Yes (X) | ||||
| KENNETH HOLMEN MD | ||||||||||
| PRESIDENT/CEO | 1.00 | Yes (X) | $0 | $1,695,149 | $66,805 | 40.00 | ||||
| BRAD SCHMIDT | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JOE FRANCIS | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| MELISSA WEBER | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| DOUG SCHMIDT | ||||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JOSEPH H KALKMAN | ||||||||||
| CHIEF HUMAN RESOURCES OFFICER | 1.00 | Yes (X) | $0 | $695,205 | $75,913 | 40.00 | ||||
| CHAD ROGGEMAN | ||||||||||
| CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | |||||
| KELLY O'FARRELL | ||||||||||
| VICE CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | |||||
| THOMAS SCHRUP MD | ||||||||||
| CPO/EVP | 0.00 | $0 | $778,663 | $56,287 | 40.00 | Yes (X) | ||||
| AMY M PORWOLL | ||||||||||
| CISO/SR VP | 0.00 | $0 | $570,663 | $46,279 | 40.00 | Yes (X) | ||||
| JOSEPH M BLONSKI MD | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $783,635 | $53,772 | 40.00 | Yes (X) | ||||
| GEORGE A MORRIS MD | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $554,883 | $54,766 | 40.00 | Yes (X) | ||||
| CHRISTOPHER BOELTER MD | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $662,072 | $1,836 | 40.00 | Yes (X) | ||||
| JOSEPH D HELLIE | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $418,016 | $52,438 | 40.00 | Yes (X) | ||||
| KATHLEEN M PARSONS | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $452,084 | $71,762 | 40.00 | Yes (X) | ||||
| CINDY FIRKINS SMITH MD | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $760,562 | $56,068 | 40.00 | Yes (X) | ||||
| DEBRA G PETERSON | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $502,740 | $39,286 | 40.00 | Yes (X) | ||||
| LYNN MCFARLING MD | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $418,017 | $69,145 | 40.00 | Yes (X) | ||||
| MARIA MALLORY | ||||||||||
| VICE PRESIDENT | 0.00 | $0 | $585,316 | $39,699 | 40.00 | Yes (X) | ||||
| JOY M PLAMANN | ||||||||||
| COO/SENIOR VP | 0.00 | $0 | $820,436 | $40,069 | 40.00 | Yes (X) | ||||
| NATHANIAL J SLINKARD | ||||||||||
| PHYSICIAN | 0.00 | $0 | $1,048,684 | $48,608 | 40.00 | Yes (X) | ||||
| LEAH SCHAMMEL | ||||||||||
| PHYSICIAN | 0.00 | $0 | $1,127,625 | $72,432 | 40.00 | Yes (X) | ||||
| DEXTER CASTA | ||||||||||
| PHYSICIAN | 0.00 | $0 | $902,460 | $40,516 | 40.00 | Yes (X) | ||||
| SASAN MOSHIRZADEH | ||||||||||
| PHYSICIAN | 0.00 | $0 | $831,976 | $52,665 | 40.00 | Yes (X) | ||||
| CRAIG BROMAN | ||||||||||
| FORMER OFFICER | 0.00 | $0 | $384,531 | $0 | 0.00 | Yes (X) | ||||
| JOHN R HERING | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | $0 | $486,729 | $77,807 | 40.00 | Yes (X) | ||||
| MICHAEL SCHRAMM | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | $0 | $476,504 | $53,059 | 40.00 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $16,352,203 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,228,247 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SHORT STOP RESTAURANTS INC | |||||
| 3701 3RD ST N | ST CLOUD | MN | 56303 | EVENTS | $139,399 |
| CAMPBELL & COMPANY | |||||
| 1 EAST WACKER DRIVE SUITE 2100 | CHICAGO | IL | 60601 | CONSULTS | $119,221 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $936,855 | FundraisingAmt |
| All Other Contributions | $6,044,353 | AllOtherContributionsAmt |
| Noncash Contributions | $169,905 | NoncashContributionsAmt |
| Total Contributions | $6,981,208 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,723,200 | TotalRevenueColumnAmt |
| Exclusion | $4,723,200 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $100,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $117,720 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$17,720 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$17,720 | TotalRevenueColumnAmt |
| Exclusion | -$17,720 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $426,306 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $936,855 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $447,486 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$21,180 | TotalRevenueColumnAmt |
| Exclusion | -$21,180 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,665,508 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,684,300 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,769,297 | TotalAmt |
| Program Services | $3,769,297 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,860 | TotalAmt |
| Program Services | $39,860 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,678 | TotalAmt |
| Fundraising | $270,678 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,753 | TotalAmt |
| Program Services | $448 | ProgramServicesAmt |
| Management And General | $1,204 | ManagementAndGeneralAmt |
| Fundraising | $1,101 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245 | TotalAmt |
| Program Services | $40 | ProgramServicesAmt |
| Management And General | $107 | ManagementAndGeneralAmt |
| Fundraising | $98 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,813 | TotalAmt |
| Management And General | $17,813 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,457 | TotalAmt |
| Management And General | $52,457 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,611 | TotalAmt |
| Management And General | $4,611 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| FEES FOR EMPLOYEES OF A | $2,061,737 | $335,857 | $901,597 | $824,283 |
| CONTRACTED SERVICES | $334,587 | $334,587 | ||
| OTHER | $34,798 | $34,798 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,588,836 | TotalAmt |
| Program Services | $4,145,502 | ProgramServicesAmt |
| Management And General | $1,012,587 | ManagementAndGeneralAmt |
| Fundraising | $1,430,747 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,726,183 | BOYAmt |
| EOY | $5,447,065 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,928,078 | BOYAmt |
| EOY | $3,428,940 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $202,325 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $198,572 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,210 | BOYAmt |
| EOY | $3,753 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,301,168 | BOYAmt |
| EOY | $70,371,289 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,216,708 | BOYAmt |
| EOY | $1,216,708 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,228,347 | BOYAmt |
| EOY | $80,467,755 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,275 | BOYAmt |
| EOY | $2,133,205 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,550 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,219 | BOYAmt |
| EOY | $152,219 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,044 | BOYAmt |
| EOY | $2,285,424 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,121,256 | BOYAmt |
| EOY | $70,344,222 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,533,047 | BOYAmt |
| EOY | $7,838,109 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,654,303 | BOYAmt |
| EOY | $78,182,331 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,228,347 | BOYAmt |
| EOY | $80,467,755 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,076,672 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,466,446 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$15,090 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,489,468 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,096,950 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,822,773 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,794,222 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,981,208 | CurrentTaxYearAmt |
| Total | $30,184,621 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,489,468 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,096,950 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,822,773 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,794,222 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,981,208 | CurrentTaxYearAmt |
| Total | $30,184,621 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $899,662 | SubstantialContributorsTotAmt |
| Public Support Total170 | $29,284,959 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,055,375 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,935,846 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,576,019 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,771,355 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,723,200 | CurrentTaxYearAmt |
| Total | $23,061,795 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $53,246,416 | TotalSupportAmt |
| Public Support CY170 | 0.55000 | PublicSupportCY170Pct |
| Public Support PY170 | 0.58220 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Donor Advised Funds Held | 27 | DonorAdvisedFundsHeldCnt |
| Donor Advised Funds Contri | $104,038 | DonorAdvisedFundsContriAmt |
| Donor Advised Funds Grants | $53,016 | DonorAdvisedFundsGrantsAmt |
| Donor Advised Funds Vl EOY | $2,578,908 | DonorAdvisedFundsVlEOYAmt |
| Disclosed Org Leg Ctrl | Yes (1) | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | Yes (1) | DisclosedForCharitablePrpsInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,524,432 | BeginningYearBalanceAmt |
| Contributions | $186,795 | ContributionsAmt |
| End Year Balance | $3,711,227 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $356,357 | BeginningYearBalanceAmt |
| Contributions | $3,168,075 | ContributionsAmt |
| End Year Balance | $3,524,432 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,110 | BeginningYearBalanceAmt |
| Contributions | $86,247 | ContributionsAmt |
| End Year Balance | $356,357 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,110 | BeginningYearBalanceAmt |
| End Year Balance | $270,110 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $270,110 | BeginningYearBalanceAmt |
| End Year Balance | $270,110 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $202,325 | OtherCostOrOtherBasisAmt |
| Depreciation | $198,572 | DepreciationAmt |
| Book Value | $3,753 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,753 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (8 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CASH & CASH EQUIVALENTS | $1,216,778 | F |
| IRREVOCABLE TRUSTS | $835,763 | F |
| REAL ESTATE PARTNERSHIPS | $1,318,439 | F |
| CORPORATE DEBT SECURITIES | $7,133 | F |
| OTHER INVESTMENTS | $1 | F |
| HEDGE FUND PARTNERSHIPS | $9,933,014 | F |
| EQUITY MUTUAL FUNDS | $42,927,739 | F |
| FIXED INCOME MUTUAL FUNDS | $14,132,422 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $70,371,289 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ANNUITIES PAYABLE | Desc |
| Amt | $152,219 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $152,219 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,429,020 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,466,446 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $18,880 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$15,090 | OtherRevenueAmt |
| Revenue Not Reported | $1,470,236 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,958,784 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$293,276 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$293,276 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,665,508 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,900,992 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $18,880 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $293,276 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $312,156 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,588,836 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,588,836 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | BENEFACTORS ENTRUST THE CENTRACARE HEALTH FOUNDATION WITH CHARITABLE FUNDS. THE BOARD BY POLICY AND AT ITS DISCRETION DESIRES TO EFFECTIVELY SECURE, MANAGE AND DISTRIBUTE THESE CHARITABLE FUNDS OF THE FOUNDATION. THIS POLICY GOVERNS THE DISTRIBUTION FROM ALL COMPONENT FUNDS OF THE FOUNDATION. STAFF SHALL ADOPT PROCEDURES TO CARRY OUT THE STATED FUND DISTRIBUTION POLICY. A BENEFACTOR OR THE BOARD OF DIRECTORS MAY CHOOSE TO CREATE EITHER A GROWTH OR EXPENDABLE FUND. A. GROWTH FUND - THE PRINCIPAL IS ENDOWED OR AVAILABLE, BUT INTENDED TO BE HELD ON A LONG-TERM BASIS TO PRODUCE INCOME. THE FOUNDATION BOARD OF DIRECTORS HAS ESTABLISHED A "SPENDING POLICY" FOR GROWTH FUNDS. THE SPENDING POLICY OUTLINES THE PERCENTAGE THAT WILL BE TRANSFERRED ANNUALLY FROM THE GROWTH FUND. B. EXPENDABLE FUND - THE PRINCIPAL IS INTENDED TO BE SPENT FOR THE STATED CHARITABLE PURPOSE. FUNDS FOR DISTRIBUTION ARE AVAILABLE UNDER FOUR PRIMARY CATEGORIES: 1.) UNRESTRICTED, 2.) FIELD OF INTEREST, 3.) ADVISED AND 4.) DESIGNATED. THESE CATEGORIES OF FUNDS ARE EITHER GROWTH OR EXPENDABLE. A DEFINITION OF EACH FUND CATEGORY IS PROVIDED: 1. UNRESTRICTED: CENTRACARE HEALTH FOUNDATION BOARD OF DIRECTORS HAS COMPLETE DISCRETION TO MAKE CHARITABLE GRANTS TO MEET THE GREATEST NEEDS THAT THE FOUNDATION IDENTIFIES. 2. FIELD OF INTEREST: DISTRIBUTIONS ARE RESTRICTED TO A CHARITABLE PURPOSE SPECIFIED BY THE BENEFACTOR (FOR EXAMPLE, A FUND FOR MEDICAL MISSION WORK OR A PEDIATRIC FUND TO HELP ALL CHILDREN WHO ARE ILL). 3. ADVISED FUND: THE BENEFACTOR (OR PERSON OR COMMITTEE DESIGNATED BY THE BENEFACTOR) CAN ADVISE CENTRACARE HEALTH FOUNDATION ON CHARITABLE DISTRIBUTIONS). THE RECOMMENDATIONS ARE ONLY ADVISORY. THE BOARD OF DIRECTORS OF THE FOUNDATION HAS LEGAL CONTROL OVER ALL DISTRIBUTIONS. 4. DESIGNATED: DISTRIBUTIONS ARE RESTRICTED TO A SPECIFIC PROGRAM, SERVICE OR PURPOSE THAT WAS NAMED BY THE BENEFACTOR AT THE TIME THE CONTRIBUTION WAS MADE TO THE FOUNDATION (FOR EXAMPLE, THE CENTRAL MINNESOTA HEART CENTER FUND OR BREAST CENTER FUND). |
| PART X, LINE 2: | THE FOUNDATION IS SUBJECT TO THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS GUIDANCE, THE FOUNDATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE-LIKELY-THAN-NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ALSO ADDRESSES DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS. MANAGEMENT EVALUATED THE TAX POSITIONS FOR THE FOUNDATION AND CONCLUDED THAT THE FOUNDATION HAD TAKEN NO UNCERTAIN INCOME TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN VALUE OF TRUSTS -15,090. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RECLASSIFY NON-CASH PRIZES -293,276. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RECLASSIFY NON-CASH PRIZES 293,276. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | HOLLY BALL | Event1Nm |
| Gross Receipts Event1 | $880,986 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $601,405 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $279,581 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $90,278 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $51,249 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $139,399 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $13,696 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $74,797 | OtherDirectExpensesEvent1Amt |
| Event2 | GALA | Event2Nm |
| Gross Receipts Event2 | $387,755 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $284,000 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $103,755 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $39,110 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $14,559 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $4,698 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $700 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $7,200 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $94,420 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $51,450 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $42,970 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $7,150 | NonCashPrizesOtherEventsAmt |
| Oth Direct Expnss Other Events | $4,650 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $1,363,161 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $936,855 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $426,306 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $136,538 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $65,808 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $144,097 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $14,396 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $86,647 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $447,486 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$21,180 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| CENTRACARE CLINIC | ||||||||
| 1200 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411806657 | 501(C)(3) | $10,066 | $0 | GENERAL SUPPORT |
| CENTRACARE HEALTH - MELROSE | ||||||||
| 525 MAIN STREET WEST | MELROSE | MN | 56352 | 411865315 | 501(C)(3) | $61,201 | $0 | GENERAL SUPPORT |
| CENTRACARE HEALTH - LONG PRAIRIE | ||||||||
| 50 CENTRACARE DRIVE | LONG PRAIRIE | MN | 56347 | 411924645 | 501(C)(3) | $107,668 | $0 | GENERAL SUPPORT |
| CENTRACARE HEALTH SYSTEM | ||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411813221 | 501(C)(3) | $1,127,772 | $0 | GENERAL SUPPORT |
| ST CLOUD HOSPITAL | ||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 410695596 | 501(C)(3) | $1,159,958 | $0 | GENERAL SUPPORT |
| CENTRACARE HEALTH - SAUK CENTRE | ||||||||
| 425 N ELM STREET | SAUK CENTRE | MN | 56378 | 452438973 | 501(C)(3) | $950,197 | $0 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS FOR HEALTH CARE EDUCATION | GrantTypeTxt |
| Recipient | 39 | RecipientCnt |
| Cash Grant | $39,860 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CENTRACARE HEALTH FOUNDATION REVIEWS GRANT APPLICATIONS AND MAKES AWARDS THREE TIMES A YEAR. GRANTS ARE REVIEWED BY THE GRANTS COMMITTEE AND RECOMMENDATIONS ARE SUBMITTED TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL. THE FOUNDATION BOARD OF DIRECTORS, IN EVALUATING GRANT APPLICATIONS, WILL BE GUIDED BY THE FOLLOWING GENERAL PRINCIPLES: 1. APPLICANTS MUST BE ELIGIBLE NOT-FOR-PROFIT OR GOVERNMENT AGENCIES. 2. PROPOSALS MUST BE CONSISTENT WITH THE MISSION STATEMENT OF THE CENTRACARE HEALTH FOUNDATION. 3. GRANTS WILL BE MADE TO PROJECTS WHICH WILL HAVE PRIMARY IMPACT IN THE FOLLOWING CENTRAL MINNESOTA COUNTIES: BENTON, CROW WING, DOUGLAS, KANDIYOHI, MEEKER, MILLE LACS, MORRISON, POPE, SHERBURNE, STEARNS, TODD, WADENA AND WRIGHT. 4. THE FOUNDATION IS RELUCTANT TO PROVIDE FUNDING FOR: ONGOING OPERATIONAL SUPPORT OR GENERAL ADMINISTRATIVE EXPENSES FOR EXISTING PROGRAMS AND CAPITAL RELATED EXPENSES. PROPOSALS THAT ADDRESS HEALTH ISSUES THROUGH PARTNERSHIPS WITH MULTIPLE INDIVIDUALS AND ORGANIZATIONS ARE ENCOURAGED. ORGANIZATIONS ARE ALLOWED ONE ACTIVE GRANT AT A TIME. FINAL REPORT MUST BE IN AND APPROVED PRIOR TO SUBMITTING A LETTER OF INQUIRY FOR A NEW PROJECT. 5. ALL DECISIONS REGARDING FUNDING WILL BE MADE WITHOUT REGARD TO RACE, COLOR, CREED, SEX, HANDICAP, RELIGION, OR NATIONAL ORIGIN OF THE GRANT SEEKER, AND WITHOUT REGARD TO AN APPLICANT'S RELATIONSHIP WITH THE CENTRACARE SYSTEM OR ITS SUBSIDIARIES. ADDITIONAL SPECIFIC ACTIONS ARE TAKEN TO REVIEW AND MONITOR SPECIFIC REQUESTS INCLUDING: 1. AT THE MEETING OF THE BOARD OF DIRECTORS, COMMITTEE MINUTES AND RECOMMENDATION VIA MINUTES WILL BE MADE BY THE GRANTS COMMITTEE. 2. NOTIFICATION WILL BE MADE FOLLOWING THE BOARD DECISION. 3. IF A GRANT APPLICATION IS APPROVED, A GRANT AGREEMENT WILL BE E-MAILED TO THE ORGANIZATION FOR REVIEW AND SIGNATURES, AND ARRANGEMENTS FOR PAYMENT AND OTHER DETAILS WILL BE ARRANGED BY THE GRANT RECIPIENT WITH THE FOUNDATION'S ADMINISTRATIVE OFFICE. 4. PROGRESS REPORTS WILL BE REQUIRED ON AT LEAST A SEMI-ANNUAL BASIS, WITH A FINAL REPORT REQUIRED AT THE CONCLUSION OF THE PROJECT. 5. IN THE EVENT A GRANT APPLICATION IS ACCEPTED, AND THE APPLICANT IS NOTIFIED, BUT THE APPLICANT MAKES NO REQUEST FOR THE FUNDS OR FOR THE DEFERRAL OF THE PROJECT IN THE SUCCEEDING 12 MONTHS, THEN THE APPLICANT MUST RESUBMIT A NEW PROPOSAL FOR CONSIDERATION. 6. IF AN ACCEPTED PROJECT IS TO HAVE TWO SEPARATE YEARLY GRANTS, THE SECOND ALLOCATION WILL NOT BE MADE WITHOUT ADEQUATE REPORTING OF THE FIRST YEAR'S ACTIVITY AND THE USE OF GRANT MONEYS. A FORMAL GRANT APPLICATION TO CCHF WILL INCLUDE THE FOLLOWING INFORMATION: 1. THE NAME OF THE APPLICANT, ADDRESS, TELEPHONE NUMBER, NAME OF PERSON PREPARING THE APPLICATION, AND THE NAME OF THE PERSON RESPONSIBLE FOR CARRYING OUT THE PROJECT. 2. A BRIEF HISTORY OF THE ORGANIZATION OR THE BACKGROUND AND RELEVANT EXPERIENCE OF AN INDIVIDUAL APPLICANT. 3. A DETAILED DESCRIPTION OF THE PROPOSED PROJECT WITH A NEEDS ASSESSMENT, AN OUTLINE OF THE PROJECT GOALS AND OBJECTIVES, AND THE PLAN FOR MEETING THOSE GOALS AND OBJECTIVES. 4. THE GEOGRAPHIC AND POPULATION SCOPE OF THE PROJECT. 5. A DESCRIPTION OF THE ANTICIPATED IMPACT THE PROJECT WILL HAVE ON THE REGION. 6. A DESCRIPTION OF THE ORGANIZATION'S RELATIONSHIP WITH OTHER ORGANIZATIONS WORKING WITH SIMILAR MISSIONS AND HOW YOU WORK TOGETHER TO AVOID DUPLICATION OF EFFORTS. 7. LIST INDIVIDUALS OR ORGANIZATIONS THAT ARE PARTNERS WITH YOUR PROJECT. 8. THE TIME PERIOD TO BE COVERED BY THE GRANT. 9. THE PROJECT BUDGET, INCLUDING SOURCES OF INCOME AND ANTICIPATED COSTS. THE GRANTS COMMITTEE MAY REQUEST AN ANNUAL AUDIT, IF APPROPRIATE. 10. POTENTIAL FOR SUSTAINABILITY OF THE PROJECT AND LONG-TERM FUNDING STRATEGIES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (24 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH HOLMEN MD | ||||||||||||||
| PRESIDENT/CEO | $0 | $1,201,731 | $0 | $191,893 | $0 | $301,525 | $0 | $37,813 | $0 | $28,992 | $0 | $1,761,954 | $0 | $299,833 |
| LEAH SCHAMMEL | ||||||||||||||
| PHYSICIAN | $0 | $1,089,228 | $0 | $38,217 | $0 | $180 | $0 | $41,000 | $0 | $31,432 | $0 | $1,200,057 | $0 | $0 |
| NATHANIAL J SLINKARD | ||||||||||||||
| PHYSICIAN | $0 | $1,014,472 | $0 | $34,032 | $0 | $180 | $0 | $20,500 | $0 | $28,108 | $0 | $1,097,292 | $0 | $0 |
| DEXTER CASTA | ||||||||||||||
| PHYSICIAN | $0 | $881,623 | $0 | $20,657 | $0 | $180 | $0 | $27,736 | $0 | $12,780 | $0 | $942,976 | $0 | $0 |
| SASAN MOSHIRZADEH | ||||||||||||||
| PHYSICIAN | $0 | $453,262 | $0 | $378,444 | $0 | $270 | $0 | $41,000 | $0 | $11,665 | $0 | $884,641 | $0 | $0 |
| JOY M PLAMANN | ||||||||||||||
| COO/SENIOR VP | $0 | $692,137 | $0 | $68,730 | $0 | $59,569 | $0 | $17,550 | $0 | $22,519 | $0 | $860,505 | $0 | $59,155 |
| JOSEPH M BLONSKI MD | ||||||||||||||
| VICE PRESIDENT | $0 | $449,116 | $0 | $36,244 | $0 | $298,275 | $0 | $27,000 | $0 | $26,772 | $0 | $837,407 | $0 | $297,087 |
| THOMAS SCHRUP MD | ||||||||||||||
| CPO/EVP | $0 | $587,778 | $0 | $71,688 | $0 | $119,197 | $0 | $27,000 | $0 | $29,287 | $0 | $834,950 | $0 | $118,423 |
| CINDY FIRKINS SMITH MD | ||||||||||||||
| VICE PRESIDENT | $0 | $611,626 | $0 | $54,760 | $0 | $94,176 | $0 | $27,000 | $0 | $29,068 | $0 | $816,630 | $0 | $92,988 |
| JOSEPH H KALKMAN | ||||||||||||||
| CHIEF HUMAN RESOURCES OFFICER | $0 | $535,495 | $0 | $65,208 | $0 | $94,502 | $0 | $47,500 | $0 | $28,413 | $0 | $771,118 | $0 | $93,728 |
| DR EDWARD MARTIN-CHAFFEE MD | ||||||||||||||
| DIRECTOR | $0 | $676,579 | $0 | $3,688 | $0 | $1,188 | $0 | $47,500 | $0 | $28,589 | $0 | $757,544 | $0 | $0 |
| CHRISTOPHER BOELTER MD | ||||||||||||||
| VICE PRESIDENT | $0 | $555,286 | $0 | $41,785 | $0 | $65,001 | $0 | $0 | $0 | $1,836 | $0 | $663,908 | $0 | $64,587 |
| MARIA MALLORY | ||||||||||||||
| VICE PRESIDENT | $0 | $561,733 | $0 | $23,169 | $0 | $414 | $0 | $20,500 | $0 | $19,199 | $0 | $625,015 | $0 | $0 |
| AMY M PORWOLL | ||||||||||||||
| CISO/SR VP | $0 | $436,278 | $0 | $43,742 | $0 | $90,643 | $0 | $27,000 | $0 | $19,279 | $0 | $616,942 | $0 | $89,869 |
| GEORGE A MORRIS MD | ||||||||||||||
| VICE PRESIDENT | $0 | $446,057 | $0 | $36,184 | $0 | $72,642 | $0 | $27,000 | $0 | $27,766 | $0 | $609,649 | $0 | $71,868 |
| JOHN R HERING | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $399,924 | $0 | $32,278 | $0 | $54,527 | $0 | $47,500 | $0 | $30,307 | $0 | $564,536 | $0 | $54,113 |
| DEBRA G PETERSON | ||||||||||||||
| VICE PRESIDENT | $0 | $482,310 | $0 | $19,211 | $0 | $1,219 | $0 | $27,000 | $0 | $12,286 | $0 | $542,026 | $0 | $0 |
| MICHAEL SCHRAMM | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $385,219 | $0 | $30,747 | $0 | $60,538 | $0 | $25,482 | $0 | $27,577 | $0 | $529,563 | $0 | $60,124 |
| KATHLEEN M PARSONS | ||||||||||||||
| VICE PRESIDENT | $0 | $370,986 | $0 | $29,190 | $0 | $51,908 | $0 | $47,250 | $0 | $24,512 | $0 | $523,846 | $0 | $50,720 |
| LYNN MCFARLING MD | ||||||||||||||
| VICE PRESIDENT | $0 | $361,710 | $0 | $29,553 | $0 | $26,754 | $0 | $47,500 | $0 | $21,645 | $0 | $487,162 | $0 | $25,566 |
| JOSEPH D HELLIE | ||||||||||||||
| VICE PRESIDENT | $0 | $334,964 | $0 | $27,502 | $0 | $55,550 | $0 | $27,000 | $0 | $25,438 | $0 | $470,454 | $0 | $54,776 |
| BRAD KONKLER | ||||||||||||||
| VICE PRESIDENT, FOUNDATION | $0 | $297,631 | $0 | $24,477 | $0 | $59,425 | $0 | $8,737 | $0 | $28,041 | $0 | $418,311 | $0 | $58,651 |
| CRAIG BROMAN | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $0 | $0 | $384,531 | $0 | $0 | $0 | $0 | $0 | $384,531 | $0 | $384,531 |
| TAMARA CONGDON MD | ||||||||||||||
| DIRECTOR | $0 | $329,163 | $0 | $3,688 | $0 | $414 | $0 | $20,500 | $0 | $25,668 | $0 | $379,433 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | FURTHER EXPLANATION OF THE OFFICERS' COMPENSATION LISTED IN SECTION VII OF FORM 990 AND ON SCHEDULE J: THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO THE FORM 990, THE AMOUNTS LISTED IN SECTION VII AND IN SCHEDULE J REFLECT THIS TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON THE FORM 990; ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: BRAD KONKLER - PAID 58,651 KENNETH HOLMAN - PAID 299,833 JOSEPH KALKMAN - PAID 93,728 |
| PART I, LINE 6 | THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON THREE DISCRETE AREAS: A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FROM CENTRACARE HEALTH FOUNDATION; ACHIEVEMENT OF IMPROVEMENT IN OVERALL EMPLOYMENT ENGAGEMENT SCORES; AND ACHIEVEMENT OF UP TO THREE INDIVIDUAL GOALS WHICH ARE TIED TO THE CENTRACARE HEALTH FOUNDATION'S STRATEGIC PLAN. |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $21,478 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | SILENT AUCTION ITEMS, JEWELRY AND GIFT CARDS FOR EVENTS | 3 | $106,038 | COST |
| Yes (X) | FOOD AND BEVERAGES FOR HEALTH CARE WORKERS & EVENTS | 7 | $32,900 | COST |
| Yes (X) | GIFT CARDS | 7 | $9,550 | COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION DELEGATES INVESTMENTS TO AN INVESTMENT COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS PREPARED BY THE ORGANIZATION'S PUBLIC ACCOUNTANT WITH THE ASSISTANCE OF THE ORGANIZATION'S PERSONNEL. ONCE COMPLETE, THE 990 IS PRESENTED TO THE BOARD MEMBERS WHERE IT IS REVIEWD, APPROVED, AND SIGNED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE ONCE A YEAR. ALL STAFF SIGN CONFLICT OF INTEREST FORMS ON AN ANNUAL BASIS FACILITATED BY CENTRACARE HEALTH SYSTEM. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRE ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE DIRECTOR IS SUBJECT TO BIENNIAL FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES BY AN OUTSIDE, INDEPENDENT CONSULTANT. THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMMITTEE AND BOARD REVIEW. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF TRUSTS -15,090. |
| FORM 990, PART XII, LINE 2C | THERE HAS BEEN NO CHANGE IN THE PROCESS FROM THE PRIOR YEAR. |
| FORM 990, PART I, LINE 1 & FORM 990, PART III, LINE 1, MISSION CONTINUE: | (G) PROMOTING THE MEDICAL, NURSING, SPIRITUAL, PHYSICAL, SOCIAL, OR PSYCHOLOGICAL CARE AND SERVICES, INCLUDING HOUSING AND OUTREACH SERVICES, FOR THE ELDERLY AND OTHER PERSONS WHO DO NOT REQUIRE ACUTE HOSPITAL CARE. (H) PROMOTING THE INTERESTS OF ANY NONPROFIT AND FEDERALLY TAX-EXEMPTED ORGANIZATION, PROVIDED HOWEVER, THE PURPOSES OF SUCH ORGANIZATION ARE CONSISTENT WITH THOSE OF THE CORPORATION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HEALTH SYSTEM | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411813221 | TO OPERATE AN INTEGRATED MULTI-ORGANIZATIONAL HEALTH SYSTEM | MN | 501(C)(3) | LINE 3 | N/A | 0 | |
| CENTRACARE HEALTH - LONG PRAIRIE | |||||||||||
| 20 SE 9TH SE | LONG PRAIRIE | MN | 56347 | 411924645 | OPERATION OF ACUTE AND LONG TERM CARE FACILITIES | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH - MELROSE | |||||||||||
| 11 NORTH 5TH AVE WEST | MELROSE | MN | 56352 | 411865315 | OPERATION OF ACUTE AND LONG TERM CARE FACILITIES | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE CLINIC | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411806657 | OPERATION OF A MULTI SPECIALTY PHYSICIAN CLINIC | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH - SAUK CENTRE | |||||||||||
| 425 ELM STREET NORTH | SAUK CENTRE | MN | 56378 | 452438973 | OPERATION OF ACUTE AND LONG TERM CARE FACILITIES | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| ST CLOUD HOSPITAL | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 410695596 | ACUTE/LT CARE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CUSHMAN ALBERT RICE TRUST | |||||||||||
| 1100 WEST ST GERMAIN STREET | ST CLOUD | MN | 56303 | 416019335 | SUPPORT FOR CARRIS HEALTH | MN | 501(C)(3) | LINE 12A, I | 0 | CARRIS HEALTH | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MONTICELLO CANCER CENTER | ||||||||||
| 1001 HART BOULEVARD SUITE 50 | MONTICELLO | MN | 55362 | 261909519 | RADIATION & ONCOLOGY SERVICES | MN | N/A | N/A | 0 | 0 |
| CENTRAL IMAGING LLC | ||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 852580688 | IMAGING SERVICES | MN | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HOLDINGS INC | |||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 472688595 | INVESTMENTS/PHARMACY | MN | CENTRACARE HEALTH SYSTEM | C | 0 |
| AFFILIATED COMMUNITY MEDICAL CENTERS PA | |||||||||
| 301 BECKER AVENUE SOUTHWEST | WILLMAR | MN | 56201 | 410850702 | HEALTHCARE SYSTEM | MN | CARRIS HEALTH | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CENTRACARE HEALTH - MELROSE | ||
| B | $61,201 | APPROVED GRANT BUDGETED AMOUNTS |
| CENTRACARE HEALTH SYSTEM | ||
| B | $1,127,772 | APPROVED GRANT BUDGETED AMOUNTS |
| CENTRACARE HEALTH - LONG PRAIRIE | ||
| B | $107,668 | APPROVED GRANT BUDGETED AMOUNTS |
| CENTRACARE HEALTH - SAUK CENTRE | ||
| B | $950,197 | APPROVED GRANT BUDGETED AMOUNTS |
| ST CLOUD HOSPITAL | ||
| B | $1,159,958 | APPROVED GRANT BUDGETED AMOUNTS |
Comments