AMERY REGIONAL MEDICAL CENTER FOUNDATION INC: Form 990, tax year 2023
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- Organization
- AMERY REGIONAL MEDICAL CENTER FOUNDATION INC (EIN 39-1726539)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-12
- IRS object ID
- 202433179349306778
- Schema version
- 2023v5.1
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-12T15:14:40-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 N 5TH STREET SUITE 600 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391726539 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AMER | BusinessNameControlTxt |
| Phone | 7152688000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBRA A RUDQUIST | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7152688000 | PhoneNum |
| Signature | 2024-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | HOLLY K MOEN | PreparerPersonNm |
| PTIN | P01800653 | PTIN |
| Phone | 6123055000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEBRA A RUDQUIST | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $482,614 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AMERYMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE THE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED BY AMERY REGIONAL MEDICAL CENTER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 86 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,168,632 | PYContributionsGrantsAmt |
| CY Contributions Grants | $311,711 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $20,850 | PYInvestmentIncomeAmt |
| CY Investment Income | $159,890 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,024 | PYOtherRevenueAmt |
| CY Other Revenue | $4,068 | CYOtherRevenueAmt |
| PY Total Revenue | $2,190,506 | PYTotalRevenueAmt |
| CY Total Revenue | $475,669 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,482,153 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,279,527 | 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 | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $0 | CYOtherExpensesAmt |
| PY Total Expenses | $1,482,153 | PYTotalExpensesAmt |
| CY Total Expenses | $3,279,527 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $708,353 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,803,858 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,817,662 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,177,545 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $107,304 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,271,045 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,710,358 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,906,500 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AMERY REGIONAL MEDICAL CENTER FOUNDATION (FOUNDATION) EXISTS TO PROMOTE THE HEALTH AND WELLNESS OF THE PEOPLE IN THE COMMUNITIES SERVED BY AMERY REGIONAL MEDICAL CENTER (ARMC) BY PARTICIPATING IN VARIOUS FUNDRAISING ACTIVITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,279,527 | ExpenseAmt |
| Grant | $3,279,527 | GrantAmt |
| Desc | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $3,279,527 | 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 | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 0 | 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 | 0 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| 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 | 0 | NondeductibleContributionsInd |
| 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 |
| 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN J BRANDT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9528836584 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVE S | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55440 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| JOYCE SCHAEFER | |||||||
| DIRECTOR & CHAIR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BRIAN BYRNES | |||||||
| DIRECTOR, SECRETARY, TRES | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JON BUSS | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BRUCE F DENNISON MD | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHARI OVERBY | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| J MARTIN NOONAN | |||||||
| DIRECTOR & VICE CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DEBRA A RUDQUIST | |||||||
| DIRECTOR & PRESIDENT | 0.50 | 49.50 | Yes (X) | $0 | $409,934 | $64,811 | Yes (X) |
| JANE JOHNSON | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| NEIL ANDERSON | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LISA RUEHLOW | |||||||
| EXECUTIVE DIRECTOR | 55.00 | 0.00 | $0 | $98,918 | $38,096 | Yes (X) | |
| DOUGLAS E JOHNSON | |||||||
| CFO | 0.50 | 54.50 | $0 | $603,783 | $44,121 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,112,635 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $147,028 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $50,300 | FundraisingAmt |
| All Other Contributions | $261,411 | AllOtherContributionsAmt |
| Noncash Contributions | $4,683 | NoncashContributionsAmt |
| Total Contributions | $311,711 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $159,890 | TotalRevenueColumnAmt |
| Exclusion | $159,890 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $11,013 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $50,300 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $6,945 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,068 | TotalRevenueColumnAmt |
| Exclusion | $4,068 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $475,669 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $163,958 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,279,027 | TotalAmt |
| Program Services | $3,279,027 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500 | TotalAmt |
| Program Services | $500 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,279,527 | TotalAmt |
| Program Services | $3,279,527 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,817,662 | BOYAmt |
| EOY | $2,577,403 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,600,142 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,817,662 | BOYAmt |
| EOY | $5,177,545 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,304 | BOYAmt |
| EOY | $3,271,045 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,304 | BOYAmt |
| EOY | $3,271,045 | 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 | $154,135 | BOYAmt |
| EOY | $111,295 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,556,223 | BOYAmt |
| EOY | $1,795,205 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,710,358 | BOYAmt |
| EOY | $1,906,500 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,817,662 | BOYAmt |
| EOY | $5,177,545 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,803,858 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $405,320 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $126,534 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $284,705 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,168,632 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $311,711 | CurrentTaxYearAmt |
| Total | $3,296,902 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $405,320 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $126,534 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $284,705 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,168,632 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $311,711 | CurrentTaxYearAmt |
| Total | $3,296,902 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $2,209,632 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,087,270 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,350 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,284 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,585 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,850 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $159,892 | CurrentTaxYearAmt |
| Total | $188,961 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,485,863 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $108,924 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.31190 | PublicSupportCY170Pct |
| Public Support PY170 | 0.33320 | PublicSupportPY170Pct |
| Ten Pct Facts Crcmstncs Test CY | Yes (X) | TenPctFactsCrcmstncsTestCYInd |
| Facts And Circumstances Test | ALTHOUGH AMERY REGIONAL MEDICAL CENTER FOUNDATION, INC. (THE FOUNDATION) DOES NOT MEET THE 33.33 PERCENT PUBLIC SUPPORT TEST DESCRIBED IN TREASURY REGULATION 1.170A-9(F)(2) FOR TAX YEAR 2023, THE FOUNDATION IS PUBLICLY SUPPORTED USING THE TEN PERCENT FACTS AND CIRCUMSTANCES TEST OF TREAS. REG. 1.170A-9(F)(3).THE FOUNDATION EXCEEDS THE TEN PERCENT SUPPORT LIMITATION. THE FOUNDATION NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A COMBINATION OF GOVERNMENTAL UNITS AND CONTRIBUTIONS MADE DIRECTLY OR INDIRECTLY BY THE GENERAL PUBLIC AS REQUIRED BY TREAS. REG. 1.170A-9(F)(3)(I). THE FOUNDATION'S AGGREGATE PUBLIC SUPPORT OVER THE PAST FIVE TAX YEARS IS AS FOLLOWS: TAX YEAR AGGREGATE PUBLIC SUPPORT2018 69.90%2019 70.28%2020 73.11%2021 72.25%2022 33.32%FOR TAX YEAR 2023, THE FOUNDATION'S AGGREGATE PUBLIC SUPPORT IS 31.19%, DUE PRIMARILY TO UNUSUAL, LARGE DONATIONS FROM AN INDEPENDENT AND UNRELATED PRIVATE FOUNDATION DONOR IN THE 2020, 2021, AND 2022 TAX YEARS. THOSE DONATIONS PROVIDED FUNDING FOR FACILITY IMPROVEMENTS TO THE INPATIENT BEHAVIORAL HEALTH UNIT AT AMERY REGIONAL MEDICAL CENTER, INC. (ARMC), THE FOUNDATION'S SOLE CORPORATE MEMBER, AND EXPANSION OF THE HOSPITAL EMERGENCY DEPARTMENT AT ARMC. DESPITE THOSE LARGE DONATIONS FROM ONE DONOR, THE FOUNDATION'S HISTORICAL AGGREGATE PUBLIC SUPPORT PERCENTAGE EXCEEDED THE 33.33 PERCENT PUBLIC SUPPORT TEST FOR TAX YEARS 2018 THROUGH 2021, AND FOR TAX YEARS 2022 AND 2023, THE FOUNDATION'S PUBLIC SUPPORT EXCEEDS THE TEN PERCENT SUPPORT LIMITATION OF TREAS. REG. 1.170A-9(F)(3)(I) BY OVER TWENTY PERCENT IN EACH YEAR, DEMONSTRATING THAT THE AMOUNT OF PUBLIC SUPPORT OF THE FOUNDATION IS SUBSTANTIAL.THE FOUNDATION IS ORGANIZED TO ATTRACT PUBLIC SUPPORT. THE FOUNDATION IS ORGANIZED AND OPERATED TO ATTRACT NEW AND ADDITIONAL PUBLIC AND GOVERNMENTAL SUPPORT ON A CONTINUOUS BASIS AS REQUIRED BY TREAS. REG. 1.170A-9(F)(3)(II). THE FOUNDATION HOLDS TWO OR THREE SIGNIFICANT FUNDRAISING EVENTS EACH YEAR. THE ANNUAL EVENTS INCLUDE A GOLF TOURNAMENT (WHICH BRINGS IN $30,000-$45,000 ANNUALLY) AND A WINE EVENT (WHICH BRINGS IN $5,000-$15,000 ANNUALLY). A THIRD FUNDRAISER IS USUALLY OFFERED AND VARIES IN ITS FOCUS AND SCOPE. THE FOUNDATION ALSO HOLDS VARIOUS SMALLER DONOR CULTIVATION EVENTS AND REACHES OUT INDIVIDUALLY TO CULTIVATE RELATIONSHIPS WITH NEW AND POTENTIAL INDIVIDUAL DONORS. THE FOUNDATION CONDUCTS A SPRING ONLINE FUNDRAISER THROUGH GIVEBIG WISCONSIN AND HOLDS A FALL/END OF YEAR LETTER CAMPAIGN ANNUALLY. THE FOUNDATION ALSO PARTICIPATES IN THE HEALTHPARTNERS EMPLOYEE GIVING CAMPAIGN EACH YEAR. IN 2023, EMPLOYEE GIVING TO THE FOUNDATION THROUGH THIS CAMPAIGN INCREASED SIGNIFICANTLY. IN 2022, 18% OF EMPLOYEES FROM ARMC AND OTHER RELATED ORGANIZATIONS IN THE HEALTHPARTNERS SYSTEM GAVE TO SUPPORT THE FOUNDATION, AND IN 2023, THE PERCENTAGE INCREASED TO 47%. THERE ARE OTHER PERTINENT FACTS AND CIRCUMSTANCES SHOWING THE FOUNDATION IS PUBLICLY SUPPORTED.PERCENTAGE OF FINANCIAL SUPPORT. AS SHOW ABOVE, THE FOUNDATION'S PERCENTAGE OF PUBLIC SUPPORT WELL EXCEEDS THE TEN PERCENT REQUIREMENT OF SECTION 1.170A-9(F)(3)(I). FOR TAX YEAR 2022, THE FOUNDATION'S PERCENTAGE OF PUBLIC SUPPORT IS 33.32%, WHICH IS 23.32% ABOVE THE TEN PERCENT REQUIREMENT. IN TAX YEAR 2023, THE FOUNDATION'S PERCENTAGE OF PUBLIC SUPPORT IS 31.19%, WHICH IS 21.19% ABOVE THE TEN PERCENT REQUIREMENT. IN ADDITION, THE FOUNDATION'S PERCENTAGE OF PUBLIC SUPPORT IN TAX YEARS 2018 THROUGH 2021 EXCEEDED THE 33.33 PERCENT PUBLIC SUPPORT TEST BY ALMOST FORTY PERCENT EACH YEAR. THE FOUNDATION'S PUBLIC SUPPORT IN THE LAST FIVE TAX YEARS IS OVERWHELMINGLY FROM GIFTS, GRANTS, AND CONTRIBUTIONS, NOT FROM INVESTMENT INCOME.SOURCES OF SUPPORT. THE FOUNDATION RECEIVES SUPPORT FROM GOVERNMENTAL UNITS AND A REPRESENTATIVE NUMBER OF PERSONS, RATHER THAN RECEIVING MOST OF ITS SUPPORT FROM THE MEMBERS OF A SINGLE FAMILY. THE FOUNDATION IS LOCATED IN THE RURAL COMMUNITY OF AMERY, WISCONSIN AND FOCUSES ITS FUNDRAISING EFFORTS IN SUPPORT OF THE HOSPITAL OPERATED BY ARMC IN AMERY, AND THE RURAL HEALTH CLINICS OPERATED BY ARMC IN THE COMMUNITIES OF AMERY, LUCK, CLEAR LAKE, AND TURTLE LAKE, WISCONSIN. THE FOUNDATION RECEIVES CONTRIBUTIONS FROM CORPORATE DONORS AND INDIVIDUAL DONORS IN THESE COMMUNITIES. THE FOUNDATION HAD 350 UNIQUE INDIVIDUAL DONORS AND 45 UNIQUE CORPORATE DONORS IN 2022 AND 2023. REPRESENTATIVE GOVERNING BODY. THE FOUNDATION'S BOARD OF DIRECTORS IS COMPRISED OF INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE PUBLIC, RATHER THAN THE PERSONAL OR PRIVATE INTERESTS OF A LIMITED NUMBER OF DONORS OR PERSONS STANDING IN A RELATIONSHIP TO DONORS. AS SUMMARIZED BELOW, EACH VOTING MEMBER OF THE FOUNDATION'S BOARD OF DIRECTORS HAS A ROLE IN THE AMERY, WISCONSIN COMMUNITY AND/OR SPECIAL KNOWLEDGE OR EXPERTISE IN RELATION TO THE FOUNDATION. THE VOTING MEMBERS OF THE FOUNDATION'S BOARD OF DIRECTORS ARE INDEPENDENT OF OTHER DONORS TO THE FOUNDATION. JOYCE SCHAEFER (DIRECTOR AND CHAIR) RETIRED FROM ARMC AFTER 34 YEARS SPENT AS A NURSE AND AS THE VICE PRESIDENT OF PATIENT CARE & CHIEF NURSING OFFICER. JOYCE IS A LONG-TERM RESIDENT OF AMERY, AND WIFE OF RETIRED CONGREGATIONAL PASTOR, BARRY SCHAEFER, WHO SERVED 34 YEARS AS THE MINISTER AT AMERY CONGREGATIONAL CHURCH. MARTY NOONAN (DIRECTOR AND VICE CHAIR) RESIDES IN THE AMERY AREA. MARTY HAS A PASSION FOR FLYING, AND HE SERVED THE UNITED STATES AS A FIGHTER PILOT AND THEN MANY YEARS AS A CAPTAIN FOR CONTINENTAL AIRLINES FLYING OVERSEAS FLIGHTS. BRIAN BYRNES (DIRECTOR AND SECRETARY/TREASURER) IS A PRACTICING ATTORNEY IN AMERY AND ACTIVE IN THE AMERY COMMUNITY CLUB (WHICH IS AMERY'S EQUIVALENT TO A CHAMBER OF COMMERCE). JON BUSS (DIRECTOR) IS A LONG-TIME RESIDENT OF AMERY, SERVING AS ONE OF THE AMERY COMMUNITY CLUB AMBASSADORS. JON HAS A BACKGROUND IN INVESTMENT BROKERAGE AND LOCAL FUNDRAISING. BRUCE DENNISON, MD (DIRECTOR) PRACTICED AS AN ENT PHYSICIAN AT ARMC AND IS NOW RETIRED. DR. DENNISON LIVES IN STILLWATER, MINNESOTA, A COMMUNITY ABOUT 40 MILES FROM AMERY. SHARI OVERBY (DIRECTOR) LIVES IN CLEAR LAKE, WISCONSIN, AND WORKS IN AMERY AS A VICE PRESIDENT OF WESTCONSIN CREDIT UNION. SHARI AND HER HUSBAND, KYLE, OWN AND OPERATE A FINANCIAL SERVICES OFFICE IN CLEAR LAKE AND AMERY. THEY ALSO OPERATE A CATTLE FARM. JANE JOHNSON (DIRECTOR) IS ACTIVE IN THE AMERY COMMUNITY AND WITH BALSAM BRANCH TRAIL SYSTEMS IN WISCONSIN. JANE SERVED AS BOARD MEMBER OF THE AMERY SCHOOL DISTRICT FOR MANY YEARS. HER HUSBAND, DR. CRAIG JOHNSON, IS A RETIRED FAMILY MEDICINE PHYSICIAN WHO AT PRACTICED ARMC. JANE ALSO SERVES ON THE ARMC BOARD OF DIRECTORS. NELL ANDERSON (DIRECTOR) HAS EXTENSIVE SUPERVISORY AND EXECUTIVE EXPERIENCE AS THE DIRECTOR OF CURRICULUM & EDUCATIONAL SERVICES IN THE WAUSAU, WISCONSIN AREA FOR MANY YEARS. IN THAT POSITION, SHE COORDINATED MULTIPLE STAKEHOLDERS FROM MULTIPLE DISTRICTS AND WORKED WITH A DIVERSE WORKFORCE AND PUBLIC POPULATION. NELL LIVES IN AMERY AND IS CURRENTLY AN OFFICER OF THE AMERY WOMAN'S CLUB AND IS ACTIVE AT OUR SAVIOR'S LUTHERAN CHURCH IN AMERY, SERVING THREE YEARS AS CHURCH COUNCIL PRESIDENT, WORKING WITH THE YOUTH AND WOMEN'S GROUPS, AND SINGING IN THE CHOIR. USING HER ENGLISH LANGUAGE INSTRUCTION SKILLS, NELL IS A VOLUNTEER TUTOR TO ENGLISH LANGUAGE LEARNERS IN THE AMERY AREA. | FactsAndCircumstancesTestTxt |
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) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AMERY REGIONAL MEDICAL CENTER FOUNDATION, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. JUDGMENT IS REQUIRED IN DETERMINING HP'S EFFECTIVE TAX RATE AND IN EVALUATING ITS TAX POSITION. HP ESTABLISHES ACCRUALS FOR UNCERTAIN TAX POSITIONS WHEN, DESPITE THE BELIEF THAT HP'S TAX RETURN POSITIONS ARE FULLY SUPPORTABLE, HP BELIEVES THAT ITS POSITION MAY NOT BE FULLY SUSTAINED, PRIMARILY GIVEN THE RISKS ASSOCIATED WITH TAX LITIGATION OR DISPUTES. THE UNCERTAIN TAX POSITION ACCRUALS ARE ADJUSTED IN LIGHT OF CHANGING FACTS AND CIRCUMSTANCES, SUCH AS THE PROGRESS OF TAX AUDITS, CASE LAW, AND EMERGING LEGISLATION. HP'S EFFECTIVE TAX RATE INCLUDES THE IMPACT OF CHANGES TO THE ACCRUALS FOR UNCERTAIN TAX POSITIONS. HP CLASSIFIES INTEREST AND PENALTIES ON TAX-RELATED MATTERS AS INCOME AND OTHER TAX EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2023 OR 2022 FOR UNRECOGNIZED TAX BENEFITS. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $47,359 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $40,256 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $7,103 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $5,701 | OtherDirectExpensesEvent1Amt |
| Event2 | WONDERFUL WORLD OF WINE | Event2Nm |
| Gross Receipts Event2 | $7,459 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $3,549 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $3,910 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $730 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $6,495 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $6,495 | CharitableContriOtherEventsAmt |
| Oth Direct Expnss Other Events | $514 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $61,313 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $50,300 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $11,013 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $6,945 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $6,945 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $4,068 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55440 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 390908320 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $3,271,339 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AMERY REGIONAL MEDICAL CENTER FOUNDATION (FOUNDATION) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH THE FOUNDATION'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO THE FOUNDATION'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS E JOHNSON | ||||||||||||||
| CFO | $0 | $386,739 | $0 | $106,273 | $0 | $110,771 | $0 | $6,600 | $0 | $37,521 | $0 | $647,904 | $0 | $0 |
| DEBRA A RUDQUIST | ||||||||||||||
| DIRECTOR & PRESIDENT | $0 | $307,131 | $0 | $91,223 | $0 | $11,580 | $0 | $26,592 | $0 | $38,219 | $0 | $474,745 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ALL OFFICER AND KEY EMPLOYEES ARE PAID BY REGIONS HOSPITAL (REGIONS), LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION OR AMERY REGIONAL MEDICAL CENTER (ARMC) RELATED ORGANIZATIONS. ANY COMPENSATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATIONS. |
| PART I, LINE 6 | THE FOUNDATION'S OFFICERS AND DIRECTORS ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS), LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (LMHA) OR AMERY REGIONAL MEDICAL CENTER (ARMC) ALL OF WHICH ARE RELATED ORGANIZATIONS. COMPENSATION REPORTED IN FORM 990, PART VII INCLUDES ANY COMPENSATION DERIVED FROM, REGIONS, LMHA, OR ARMC LEADERSHIP INCENTIVE PROGRAMS WHICH INCENT AND REWARD BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGAMS ARE A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. THE LEADERSHIP INCENTIVE PROGRAMS' REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G., SENIOR VICE PRESIDENT, VICE PRESIDENT, DIRECTOR MANAGER, OR OTHER SPECIFICALLY IDENTIFIED LEADERS) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE, BUT ARE NOT LIMITED TO, PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, HEALTH EQUITY, HEALTHCARE AFFORDABILITY MEASURES, HEALTH PLAN AND CARE DELIVERY MARKET SHARE, STRATEGIC CAPABILITIES, HOSPITAL AND CLINIC QUALITY MEASURES, FINANCIAL PERFORMANCE (OPERATING INCOME), ETC AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. AN OPERATING INCOME THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A - "EXEMPT PURPOSE AND ACHIEVEMENTS" | CORPORATE STRUCTURE, PURPOSE, GOVERNANCE AMERY REGIONAL MEDICAL CENTER FOUNDATION, INC. (THE FOUNDATION), IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE HEALTHPARTNERS ORGANIZATION ("HEALTHPARTNERS"). FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED HEALTH CARE ORGANIZATION, PROVIDING HEALTH CARE SERVICES AND HEALTH PLAN FINANCING AND ADMINISTRATION. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS, AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTH CARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS, INC. (HPI) IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4) AND IS THE PARENT ENTITY OF HEALTHPARTNERS ORGANIZATIONS REFERRED TO COLLECTIVELY AS "HEALTHPARTNERS". HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS. HEALTHPARTNERS PROVIDES A FULL RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLANS SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 2,000 EMPLOYED PHYSICIANS AND DENTISTS, EIGHT OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 100 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN SERVING MORE THAN 1.34 MILLION PATIENTS. HEALTHPARTNERS HEALTH PLANS CONTRACT WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS, AND RELATED HEALTHCARE PROVIDERS TO SERVE PLAN MEMBERS. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. HEALTHPARTNERS COLLABORATES WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES ARE TOTAL COST OF CARE MEASUREMENTS (A NATIONALLY RECOGNIZED METRIC, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), EQUITY, INCLUSION, AND ANTI-RACISM (ADDRESSING HEALTH EQUITY, ELIMINATING HEALTH CARE DISPARITIES, INCREASING DIVERSITY AND INCLUSION IN OUR WORKPLACES, BUILDING AN ANTI-RACIST CULTURE, AND DEEPENING OUR COLLECTIVE UNDERSTANDING OF CULTURAL HUMILITY) AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN HEALTHPARTNERS, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NONPROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, LAKEVIEW HEALTH, AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN AND GROUP HEALTH PLAN, INC. (GHI) ARE CORPORATE MEMBERS OF AMERY REGIONAL MEDICAL CENTER, INC. (ARMC). ARMC IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3). IN TURN, ARMC IS THE SOLE CORPORATE MEMBER OF THE FOUNDATION. AMERY REGIONAL MEDICAL CENTER IS DOING BUSINESS AS AMERY HOSPITAL & CLINIC (AHC). THE FOUNDATION EXISTS TO PROMOTE THE HEALTH AND WELLNESS OF THE PEOPLE IN THE COMMUNITIES SERVED BY ARMC BY PARTICIPATING IN VARIOUS FUNDRAISING ACTIVITIES. BENEFIT TO THE COMMUNITY FUNDRAISERS WE HELD THREE PUBLIC FUNDRAISING EVENTS THIS YEAR, AND SEVERAL SMALLER EVENTS INCLUDING: THE INTERNAL EMPLOYEE GIVING CAMPAIGN; PARTICIPATING IN "ST. CROIX VALLEY'S GIVE BIG" DAY OF ONLINE GIVING TO SUPPORT NON-PROFITS; AND AN END-OF-THE-YEAR LETTER CAMPAIGN. IN JANUARY, WE HELD OUR FIRST EVER PAINT-N-SIP EVENT AND RAISED FUNDS TO PURCHASE NEW ARTWORK BY LOCAL ARTISTS IN HIGH VISIBILITY, PUBLIC SPACES THAT ENCOURAGE HEALING AND CELEBRATE COMMUNITY CONNECTIONS. THE ART ENHANCES PATIENT EXPERIENCE AND HEALING IN OUR NEW CHEMO INFUSION CENTER AND RENOVATED AND EXPANDED EMERGENCY DEPARTMENT AT AMERY HOSPITAL & CLINIC. THIS EVENT EARNED $6,495 OUR MAJOR FUNDRAISER WAS OUR 35TH ANNUAL GOLF CLASSIC IN SEPTEMBER. THIS EVENT SURPASSED OUR FUNDRAISING GOAL AND BECAME THE LARGEST FUNDRAISER EVER FOR THE ARMC FOUNDATION, RAISING NEARLY $47,000 (NETTING OVER $40,000) TO SUPPORT COMMUNITY HEALTH PROGRAMS LIKE POWERUP IN AMERY. WE BROUGHT BACK OUR WONDERFUL WORLD OF WINE EVENT, WHICH HAD NOT BEEN POSSIBLE SINCE 2019 DUE TO THE PANDEMIC. THIS EVENT FEATURED THE WINE MAKER AND OWNER OF CHATEAU ST. CROIX TEACHING AND GUIDING THROUGH FIVE SERIES OF WINE TASTINGS, ACCOMPANIED BY FIVE COURSES PREPARED BY A LOCAL GOURMET CHEF. THE EVENT NETTED $6,729 TO SUPPORT EMERGENCY PATIENT NEEDS THROUGH OUR GOOD SAMARITAN FUND. APRIL'S "ONE CAMPAIGN" RAISED $26,585.45 IN EMPLOYEE GIVING IN 2023 WITH OVER 46% OF EMPLOYEES PLEDGING TO PARTICIPATE. THIS WAS AN ENORMOUS INCREASE OVER LAST YEAR'S 18% EMPLOYEE PARTICIPATION. EMPLOYEES DIRECTED THESE FUNDS TO COMMUNITY GIVING, HOSPITAL SUPPORTED PROGRAMS, THE EMERGENCY DEPARTMENT UPGRADE, COMMUNITY HEALTH INITIATIVES, PATIENT CARE NEEDS, EMPLOYEE-TO-EMPLOYEE ASSISTANCE, THE GOOD SAMARITAN FUND, AND TO THE FOUNDATION'S GREATEST NEEDS FUND. OUR END-OF-THE-YEAR LETTER CAMPAIGN RAISED $6,420.00 FOR POWERUP AND THE FOUNDATION'S GREATEST NEEDS FUND. DONATIONS RECEIVED: IN ADDITION TO THESE FUNDRAISING EVENTS, WE RECEIVED $10,883.16 IN ANNUAL GIVING, $5,622.89 IN MEMORIAL GIFTS AND NON-MONETARY GIFTS VALUED BY THEIR DONORS AT $4,683.00. |
| FORM 990, PART III, LINE 4A - "EXEMPT PURPOSE AND ACHIEVEMENTS" | GRANTS RECEIVED IN 2023, OUR FUNDRAISING FOCUSED ON THREE AREAS: 1) FUNDING THE PURCHASE OF CRITICALLY NEEDED MEDICAL EQUIPMENT TO SERVE PATIENT NEEDS IN OUR HOSPITAL AND CLINIC, 2) FUNDING COMMUNITY HEALTH PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF PATIENTS, FAMILIES, AND COMMUNITY MEMBERS THROUGH PROGRAMS SUCH AS POWERUP, MAKE IT OK, AND FAITH COMMUNITY NURSING, 3) THE PURCHASE OF ORIGINAL ARTWORK TO CREATE A HEALING ENVIRONMENT THROUGH ARTWORK CREATED BY LOCAL ARTISTS, AND 4) PURCHASING EQUIPMENT AND TRAINING TO ESTABLISH THE VIRTUAL CONNECTION TO NEONATAL SPECIALISTS AT MINNESOTA CHILDREN'S HOSPITAL TO SUPPORT AT-RISK BIRTHS. THE FOUNDATION RECEIVED $213,636.50 IN GRANTS DIRECTLY, AND WE FACILITATED AN ADDITIONAL $550,000 IN GRANTS FROM A PRIVATE FOUNDATION AND FROM A FEDERAL PROGRAM, BOTH OF WHICH WERE GIVEN DIRECTLY TO THE HOSPITAL. GRANTS RECEIVED, GIVEN DIRECTLY TO THE FOUNDATION IN 2023: -$150,000 FROM THE OTTO BREMER TRUST FOR THE EMERGENCY DEPARTMENT RENOVATION AND EXPANSION -$43,800 FROM THE HEALTH & WELLNESS FUND OF ARMC, WHICH IS INVESTED AT THE ST. CROIX VALLEY FOUNDATION. THIS GRANT WAS TO SUPPORT AMERY'S POWERUP COMMUNITY HEALTH PROGRAM TO HELP KIDS AND FAMILIES MOVE MORE, EAT HEALTHY AND FEEL BETTER. -$13,834 FROM THE HEALTH & WELLNESS FUND OF ARMC AT THE ST. CROIX VALLEY FOUNDATION FOR AMERY'S MAKE IT OK COMMUNITY HEALTH PROGRAM TO PROVIDE TRAINING AND REDUCE STIGMA SURROUNDING MENTAL HEALTH. -$5,815 FROM THE HEALTH & WELLNESS FUND OF ARMC AT THE ST. CROIX VALLEY FOUNDATION TO SUPPORT GREATEST NEEDS OF THE FOUNDATION, INCLUDING COMMUNITY HEALTH AND WELLNESS. HOSPITAL SUPPORTED PROGRAMS/COMMUNITY CONTRIBUTIONS THE FOUNDATION STRATEGICALLY PARTNERS WITH AHC TO ENHANCE PATIENT CARE, TO PROVIDE EVIDENCE-BASED TRAINING FOR STAFF, AND TO PROMOTE HEALTH AND WELLBEING WITHIN THE COMMUNITY. PROGRAM HIGHLIGHTS FROM 2023: EQUIPMENT PURCHASES TO ENHANCE PATIENT CARE: $3,500 TO PURCHASE WIRELESS HEADPHONES, MP3 PLAYERS AND ANNUAL SPOTIFY SUBSCRIPTION TO START MUSIC THERAPY PROGRAM FOR PATIENTS IN OUR IN-PATIENT BEHAVIORAL HEALTH UNIT. $1,000 TO PURCHASE TWO NEW WHEELCHAIRS FOR THE FRONT DESK REGISTRATION AREA. FOR CONTINUED DEVELOPMENT AND SUPPORT OF STAFF: $1,700 TO SPONSOR A CONFERENCE FOR NURSES AT AMERY HOSPITAL & CLINIC EMPLOYEE EMERGENCY: THE FOUNDATION PROVIDED $2,000 OF SUPPORT TO EMPLOYEES WHO WERE IN A TEMPORARY FINANCIAL CRISIS DUE TO A PERSONAL EMERGENCY SITUATION. THESE FUNDS WERE GIVEN IN A VERY SELECTIVE PROCESS AND WERE REQUESTED BY EMPLOYEES THEMSELVES. COMMUNITY CONTRIBUTIONS: $107,051 TO COMMUNITY HEALTH PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF PATIENTS, FAMILIES, AND COMMUNITY MEMBERS THROUGH POWER UP, MAKE IT OK, AND FAITH COMMUNITY NURSING PROGRAMS. $500 IN EDUCATIONAL SCHOLARSHIPS $300 FROM OUR GOOD SAMARITAN FUND FOR GAS-ONLY GIFT CARDS TO PROVIDE TRANSPORTATION TO PATIENTS IN EMERGENT NEED. $1,600.00 FROM OUR GOOD SAMARITAN FUND TO PURCHASE DURABLE MEDICAL SUPPLIES AND DISCHARGE PRESCRIPTIONS FOR TWO PATIENTS IN CRITICAL NEED. MONETARY SUPPORT FOR THE PURCHASE OF TWO PALLETS OF DIAPERS FOR UNITED WAY OF POLK COUNTY'S DIAPER DRIVE. $1,000 COMMUNITY GARDEN: THE FOUNDATION SUPPORTED THE COMMUNITY GARDEN PROGRAM FOR OPERATIONAL EXPENSES OF THE 20 COMMUNITY-WIDE GARDEN PLOTS AND FRUIT TREES ON SITE AT ARMC, WHICH DONATES LAND FOR THIS USE. MASTER GARDENERS GREW AND DONATED FRESH VEGETABLES TO THE AMERY AREA FOOD SHELF. IN 2023, THE FOUNDATION PARTNERED WITH HUMAN RESOURCES TO OFFER A PROGRAM OF UP TO THREE SPONSORSHIP SCHOLARSHIPS TO STUDENTS IN OUR SERVICE AREA. THESE RENEWABLE SCHOLARSHIPS COVER THE COST OF TUITION, BOOKS AND ACADEMIC FEES OF UP TO $2,500 PER SEMESTER WITH A MAXIMUM OF $10,000 OVER THE LIFE OF THE PROGRAM FOR EACH STUDENT WHO ENROLLS IN ONE OF SEVERAL SPONSORED PROGRAMS AT AN ACCREDITED TECHNICAL COLLEGE OF THEIR CHOICE. AFTER MEETING PROGRAM CRITERIA AND SUCCESSFUL GRADUATION FROM THE STUDENT'S CHOSEN PROGRAM, THERE WILL BE A JOB OPPORTUNITY AWAITING THEM AT AMERY HOSPITAL & CLINIC. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER OF THE FOUNDATION IS ARMC. |
| FORM 990, PART VI, SECTION A, LINE 7A | PURSUANT TO BYLAWS, THE FOUNDATIONS BOARD OF DIRECTORS IS COMPRISED OF AT LEAST 5 BUT NO MORE THAN 9 PERSONS. AT LEAST 2 DIRECTORS MUST BE APPOINTED BY ARMC, THE FOUNDATION'S SOLE MEMBER, AND THE REMAINING DIRECTOR POSITIONS ARE FILLED BY PERSONS NOMINATED BY THE BOARD AND APPROVED BY THE ARMC. THE PRESIDENT OF ARMC SERVES AS AN EX-OFFICIO, NON-VOTING DIRECTOR. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOUNDATION'S CORPORATE MEMBER, ARMC, MUST APPROVE THE FOLLOWING ACTIONS OF THE FOUNDATION'S BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY: A. ADOPTION OF THE FOUNDATION'S ANNUAL BUDGET B. ADOPTION OF THE FOUNDATION'S STRATEGIC PLANS C. AMENDMENT OF THE FOUNDATION'S BYLAWS D. AMENDMENT OF THE FOUNDATION'S ARTICLES OF INCORPORATION E. ANY CHANGE, AMENDMENT, OR ALTERATION IN THE SLATED PURPOSES FOR WHICH THE FOUNDATION IS ORGANIZED F. ANY GRANT GREATER THAN $10,000 TO AN ENTITY OTHER THAN ARMC OR ANY ENTITY AFFILIATED WITH ARMC G. ELECTION OF THE FOUNDATION'S OFFICERS |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FOUNDATION'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE FOUNDATION. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE FOUNDATION, GHI'S INTERNAL LEGAL DEPARTMENT AND THE FOUNDATION'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF THE FOUNDATION. ONCE THAT REVIEW PROCESS HAS BEEN COMPLETED, IT IS THE POLICY OF THE FOUNDATION TO MAKE AVAILABLE TO THE BOARD OF DIRECTORS OF THE FOUNDATION A COPY OF THE 990 PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT A MEETING OF THE FULL BOARD OF DIRECTORS. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN MINUTES OF THE MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE AMERY REGIONAL MEDICAL CENTER FOUNDATION BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES ("COVERED PERSONS") BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, COVERED PERSONS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND ASKED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE GENERAL COUNSEL OF HEALTHPARTNERS REVIEWS THE QUESTIONNAIRE RESPONSES AND DEVELOPS A REPORT DETAILING ANY POTENTIALLY MATERIAL CONFLICTS FOR THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD OR APPROPRIATE COMMITTEE ENDING WITH A REMINDER TO COVERED PERSONS OF THE POLICY'S MANDATE THAT EACH PERSON IS OBLIGATED TO DISCLOSE ANY NEW POTENTIAL CONFLICTS AS THEY MAY ARISE THROUGHOUT THE YEAR. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. IF A DISCLOSED CONFLICT OF INTEREST IMPACTS AN AGENDA ITEM OR DECISION, THE COVERED PERSON WOULD BE EXCLUDED FROM VOTING AND MAY BE EXCLUDED FROM RECEIVING INFORMATION AND/OR PARTICIPATING IN DELIBERATIONS, DEPENDING ON THE CIRCUMSTANCES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ALL OFFICER AND KEY EMPLOYEES ARE PAID BY REGIONS HOSPITAL (REGIONS), LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION OR AMERY REGIONAL MEDICAL CENTER (ARMC) RELATED ORGANIZATIONS. ANY COMPENSATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATIONS. THEREFORE, PART VI, SECTION B, QUESTION 15 IS NOT APPLICABLE TO THE FOUNDATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE FOUNDATION OR HEALTHPARTNERS. |
| 990, PART VII, SECT A, LN 1A, COL (B): AVERAGE HRS - RELATED ORGANIZATION | ALL DIRECTORS AND OFFICERS OF THE FOUNDATION ARE EMPLOYED AND COMPENSATED BY GROUP HEALTH PLAN, INC., REGIONS HOSPITAL OR AMERY REGIONAL MEDICAL CENTER. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(4) | N/A | 0 | ||
| HPI-RAMSEY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411793333 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| GROUP HEALTH PLAN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HEALTHPARTNERS INC | |
| RH WISCONSIN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 202287016 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HPI - RAMSEY | |
| HEALTHPARTNERS INSTITUTE | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411670163 | HEALTHCARE EDUCATION AND RESEARCH | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| CAPITOL VIEW TRANSITIONAL CARE CENTER | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 412011453 | TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410956618 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411888902 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HPI - RAMSEY | |
| RHSC INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411891928 | HEALTHCARE STAFFING AND INTENSE REHAB SERVICES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HEALTHPARTNERS INC | |
| HUDSON HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390804125 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN INC | |
| HUDSON HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391279567 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HUDSON HOSPITAL INC | |
| LAKEVIEW HEALTH FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411386635 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | LAKEVIEW HEALTH | |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410811697 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | LAKEVIEW HEALTH | |
| STILLWATER MEDICAL GROUP | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 830379473 | CLINIC STAFF AND FACILITIES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | LAKEVIEW HEALTH | |
| LAKEVIEW HEALTH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 300221189 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| WESTFIELDS HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390808442 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN INC | |
| WESTFIELDS HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391770913 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | WESTFIELDS HOSPITAL INC | |
| PARK NICOLLET HEALTH SERVICES | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 363465840 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(2) | HEALTHPARTNERS INC | |
| PARK NICOLLET FOUNDATION | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 237346465 | SUPPORT TO RELATED ENTITIES AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET METHODIST HOSPITAL | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410132080 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET HEALTH CARE PRODUCTS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 010638901 | DURABLE MEDICAL EQUIPMENT AND OTHER HEALTH CARE RETAIL SALES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET CLINIC | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410834920 | CLINIC SERVICES | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PNMC HOLDINGS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411741792 | HEALTHCARE REAL ESTATE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| AMERY REGIONAL MEDICAL CENTER INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390908320 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN INC | |
| HUTCHINSON HEALTH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 841715908 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| HUTCHINSON HEALTH FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 363317820 | PROVIDE SUPPORT TO HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HUTCHINSON HEALTH | |
| HEALTHPARTNERS RC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 844261122 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1)(A)(III) | PARK NICOLLET HEALTH SERVICES | |
| OLIVIA HOSPITAL & CLINIC FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411839619 | PROVIDE SUPPORT TO HOSPITAL | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS RC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS ADMINISTRATORS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411629390 | THIRD PARTY ADMINISTRATOR | MN | HEALTHPARTNERS INC | C | 0 |
| HEALTHPARTNERS ASSOCIATES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 522365151 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS SERVICES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683568 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS INSURANCE COMPANY | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683523 | MEDICAL AND DENTAL INSURANCE | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| DENTAL SPECIALTIES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 451297583 | PROFESSIONAL DENTAL SERVICES | MN | HEALTHPARTNERS ADMINISTRATORS INC | 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 | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | 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 |
Comments