CENTRAL MINNESOTA DIAGNOSTIC INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL MINNESOTA DIAGNOSTIC INC (EIN 36-3397264)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-10-26
- IRS object ID
- 202312999349301036
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-10-26T18:00:48+00:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363397264 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Minnesota Diagnostic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3209836300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 158 | AddressLine1Txt |
| City | MILACA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563531221 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Chad Cooper | PersonNm |
| Person Title | President/CEO | PersonTitleTxt |
| Signature | 2023-10-26 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Chad | PersonFirstNm |
| Person Last | Cooper | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chad Cooper | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 158 | AddressLine1Txt |
| City | MILACA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563531221 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $44,631,788 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cmdi.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | To provide diagnostic services to certain Section 501(c)(3) hospital organizations engaging in healthcare activities. | ActivityOrMissionDesc |
| Voting Members Governing Body | 35 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 32 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,376,700 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $42,857,375 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,071,250 | CYProgramServiceRevenueAmt |
| PY Investment Income | $960,403 | PYInvestmentIncomeAmt |
| CY Investment Income | $510,334 | CYInvestmentIncomeAmt |
| PY Other Revenue | $50,297 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $45,244,775 | PYTotalRevenueAmt |
| CY Total Revenue | $44,581,584 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $29,316,207 | PYOtherExpensesAmt |
| CY Other Expenses | $30,817,865 | CYOtherExpensesAmt |
| PY Total Expenses | $29,316,207 | PYTotalExpensesAmt |
| CY Total Expenses | $30,817,865 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,928,568 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $13,763,719 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $54,188,890 | TotalAssetsBOYAmt |
| Total Assets EOY | $55,290,013 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,139,556 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,549,656 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $44,049,334 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $44,740,357 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide diagnostic services to certain Section 501(c)(3) hospital organizations engaging in healthcare activities. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $29,482,536 | ExpenseAmt |
| Revenue | $44,071,250 | RevenueAmt |
| Desc | Central Minnesota Diagnostic Inc. provides hospital inpatient and outpatient diagnostic services. In 2022, the organization performed 362,865 ultrasound, mammography, CT scanner, nuclear medicine, bone densitometry and MRI procedures. | Desc |
| Total Program Service Expenses | $29,482,536 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 35 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 32 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | 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 | Chad Cooper | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3209836327 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 158 | AddressLine1Txt |
| City | MILACA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563531221 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (42 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Randy Ulseth | |||||||||
| Chair | 0.5 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Rick Breuer | |||||||||
| Vice Chair | 0.5 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Aaron Saude | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Amy Hart | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Ben Koppelman | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Ben Koppelman | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Bill Nelson | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Brad Burris | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Brandon Pietsch | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Bryan Bauck | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Carrie Allex | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Chelsie Falk | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Chuck Hofius | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Dan Enderson | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Dave Nelson | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Gordy Lewis | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Jason Douglas | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Jean MacDonell | |||||||||
| Director | 0.5 | 40.0 | Yes (X) | $0 | $515,552 | $71,098 | |||
| Jim Lyons | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Joel Beiswenger | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| John Hering MD | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Jose Alba | |||||||||
| Director, new 5-2022 | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Karen Whiley | |||||||||
| Director | 0.5 | 40.0 | Yes (X) | $0 | $304,290 | $38,852 | |||
| Ken Westman | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Kirk Stensrud | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Kurt Waldbillig | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Michael Coyle | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Rick Ash | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Rob Cunningham | |||||||||
| Director, new 5-2022 | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Robb Pastor | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Shelby Medina | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Teresa Debevec | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Thomas Witt MD | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Tim Rice | |||||||||
| Director | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Tim Weir | |||||||||
| Director, ended 5-2022 | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Chad Cooper | |||||||||
| President | 40.0 | 0.0 | Yes (X) | $0 | $445,174 | $84,920 | |||
| Caity Eggen | |||||||||
| VP | 40.0 | 0.0 | $0 | $184,152 | $32,147 | Yes (X) | |||
| Brent Heemstra | |||||||||
| MRI Tech | 40.0 | 0.0 | $0 | $121,290 | $28,576 | Yes (X) | |||
| Jered Nyquist | |||||||||
| MRI Tech | 40.0 | 0.0 | $0 | $144,762 | $19,390 | Yes (X) | |||
| Michael Awe | |||||||||
| Nuc Med Tech | 40.0 | 0.0 | $0 | $119,650 | $27,659 | Yes (X) | |||
| Shana Benson | |||||||||
| Ultrasound Supervisor | 40.0 | 0.0 | $0 | $190,451 | $16,449 | Yes (X) | |||
| Spencer Feldt | |||||||||
| Nuc Medicine Supervisor | 40.0 | 0.0 | $0 | $148,125 | $10,145 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,173,446 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $329,236 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Siemens | |||||
| Dept CH 14195 | Palatine | IL | 600554195 | Equip. Repair & Maint. | $4,308,909 |
| Delta Medical Systems | |||||
| 3280 Gateway Road Suite 200 | Brookfield | WI | 53045 | Equip. Repair & Maint. | $3,094,778 |
| GE Precision Healthcare | |||||
| PO Box 96483 | Chicago | IL | 60693 | Equip. Repair & Maint. | $1,262,577 |
| Northern Imaging | |||||
| 1325 Qunicy St NE Suite A2 | Minneapolis | MN | 55413 | Equip. Repair & Maint. | $1,006,947 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Diagnostic Services | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $44,071,250 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,071,250 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,071,250 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $346,438 | TotalRevenueColumnAmt |
| Exclusion | $346,438 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $214,100 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $50,204 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $163,896 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,896 | TotalRevenueColumnAmt |
| Exclusion | $163,896 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,581,584 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,071,250 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $510,334 | ExclusionAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,875,707 | TotalAmt |
| Program Services | $7,919,310 | ProgramServicesAmt |
| Management And General | $956,397 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,178 | TotalAmt |
| Management And General | $33,178 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,027 | TotalAmt |
| Program Services | $61,023 | ProgramServicesAmt |
| Management And General | $109,004 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,197 | TotalAmt |
| Management And General | $24,197 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,851 | TotalAmt |
| Program Services | $12,468 | ProgramServicesAmt |
| Management And General | $35,383 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,081 | TotalAmt |
| Management And General | $16,081 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,429 | TotalAmt |
| Program Services | $51,865 | ProgramServicesAmt |
| Management And General | $22,564 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $605,200 | TotalAmt |
| Program Services | $565,431 | ProgramServicesAmt |
| Management And General | $39,769 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,106 | TotalAmt |
| Program Services | $184,106 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,648,181 | TotalAmt |
| Program Services | $9,627,712 | ProgramServicesAmt |
| Management And General | $20,469 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,986 | TotalAmt |
| Program Services | $224,259 | ProgramServicesAmt |
| Management And General | $29,727 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Repairs & Maintenance | $10,249,358 | $10,241,211 | $8,147 |
| Medical Supplies | $560,002 | $560,002 | |
| Professional Affiliations | $54,634 | $33,231 | $21,403 |
| Community Contributions | $18,800 | $18,800 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,128 | TotalAmt |
| Program Services | $1,918 | ProgramServicesAmt |
| Management And General | $210 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,817,865 | TotalAmt |
| Program Services | $29,482,536 | ProgramServicesAmt |
| Management And General | $1,335,329 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,431,548 | BOYAmt |
| EOY | $2,629,617 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,745,136 | BOYAmt |
| EOY | $5,811,350 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,279,124 | BOYAmt |
| EOY | $5,576,492 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $872,174 | BOYAmt |
| EOY | $1,022,183 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $129,200,484 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $98,027,546 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,528,383 | BOYAmt |
| EOY | $31,172,938 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,332,525 | BOYAmt |
| EOY | $9,077,433 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,188,890 | BOYAmt |
| EOY | $55,290,013 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,057,158 | BOYAmt |
| EOY | $3,134,186 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,082,398 | BOYAmt |
| EOY | $7,415,470 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,139,556 | BOYAmt |
| EOY | $10,549,656 | EOYAmt |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,049,334 | BOYAmt |
| EOY | $44,740,357 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,049,334 | BOYAmt |
| EOY | $44,740,357 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,188,890 | BOYAmt |
| EOY | $55,290,013 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $13,763,719 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,530,383 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$11,542,313 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,500 | OtherCostOrOtherBasisAmt |
| Book Value | $13,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $334,381 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,281 | DepreciationAmt |
| Book Value | $289,100 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $127,480,628 | OtherCostOrOtherBasisAmt |
| Depreciation | $97,982,265 | DepreciationAmt |
| Book Value | $29,498,363 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,371,975 | OtherCostOrOtherBasisAmt |
| Book Value | $1,371,975 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $31,172,938 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $43,051,201 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$1,530,383 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | -$1,530,383 | RevenueNotReportedAmt |
| Revenue Subtotal | $44,581,584 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $44,581,584 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $30,817,865 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $30,817,865 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $30,817,865 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jean MacDonell | ||||||||||||||
| Director | $0 | $372,868 | $0 | $142,100 | $0 | $584 | $0 | $69,797 | $0 | $1,302 | $0 | $586,650 | $0 | $0 |
| Karen Whiley | ||||||||||||||
| Director | $0 | $269,007 | $0 | $33,709 | $0 | $1,574 | $0 | $18,300 | $0 | $20,552 | $0 | $343,142 | $0 | $0 |
| Chad Cooper | ||||||||||||||
| President | $0 | $368,562 | $0 | $75,499 | $0 | $1,113 | $0 | $64,007 | $0 | $20,913 | $0 | $530,094 | $0 | $0 |
| Caity Eggen | ||||||||||||||
| VP | $0 | $158,081 | $0 | $25,527 | $0 | $544 | $0 | $10,780 | $0 | $21,367 | $0 | $216,299 | $0 | $0 |
| Shana Benson | ||||||||||||||
| Ultrasound Supervisor | $0 | $189,243 | $0 | $750 | $0 | $458 | $0 | $6,965 | $0 | $9,484 | $0 | $206,900 | $0 | $0 |
| Spencer Feldt | ||||||||||||||
| Nuc Medicine Supervisor | $0 | $135,427 | $0 | $4,750 | $0 | $7,948 | $0 | $8,874 | $0 | $1,271 | $0 | $158,270 | $0 | $0 |
| Jered Nyquist | ||||||||||||||
| MRI Tech | $0 | $143,640 | $0 | $750 | $0 | $372 | $0 | $8,764 | $0 | $10,626 | $0 | $164,152 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: CHAD COOPER, JEAN MACDONELL |
| Schedule J, Part I, Line 7 Non-fixed payments | Fairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved. |
| Schedule J, Part I, Line 3 Related Org to establish compensation | THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS. |
| Schedule J, Part III Other Additional Information | The Plan is only open to a select group of highly compensated employees. The Plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. The contribution is unfunded. The Plan complies with section 457(f) of the Code. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 2a Additional Information | Central Minnesota Diagnostic Inc. leases employees from an affiliated organization, Fairview Health Services, a 501(c)(3) tax-exempt, non-profit organization. Therefore, Fairview Health Services files the appropriate W-3 and related W-2 tax forms for these individuals instead of Central Minnesota Diagnostic Inc. |
| Form 990, Part VI, Line 3 Delegation of management duties | Central Minnesota Diagnostic, Inc. contracts with Fairview Health Services to manage a variety of accounting and financial duties. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The members consist of those entities that utilize the services of Central Minnesota Diagnostics Services. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Those elected are based on participation. Those on the board are representative of those utilizing the services. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The Form 990 is prepared and reviewed by Fairview Health Services tax department. It is then reviewed by CMDI's Financial Operations Specialist and CEO. The Form 990 is available to board members at their request. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Conflict of interest surveys are completed and reviewed by the board and any possible issue is resolved. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The President of Central Minnesota Diagnostic, Inc. receives their salary as a Vice President of Fairview Health Services and is subject to Fairview's compensation determination process. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | The Vice President of Central Minnesota Diagnostic, Inc. (CMDI) is determined by the President of CMDI, and is subject to CMDI's compensation determination process. |
| Form 990, Part VI, Line 19 Required documents available to the public | Central Minnesota Diagnostic, Inc makes its governing documents, conflict of interest policy, and financial statements available to the public upon request and inspection of the documents is available at the corporate finance department. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Distribution to Member Organizations - -11542313; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fairview Health Services | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2450 Riverside Avenue | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55454 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410991680 | EIN |
| Primary Activities | Health Care | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments