2023-11-10T11:21:03-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-01-01 274116873 ALLINA HEALTH FOUNDATION AS OF 4122 FKA ALLINA ASSOCIATED FOUNDATION ALLI 6122620660 PO BOX 43 MR 10890 MINNEAPOLIS MN 554400043 RICHARD E MAGNUSON CHIEF FINANCIAL OFFICER 6122620660 2023-11-08 1 RICHARD MAGNUSON 999009999 0 MACKENZIE MCNAUGHTON P02025805 6123764500 2023-11-08 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z X TROY LINDLOFF PO BOX 43 MR 10890 MINNEAPOLIS MN 554400043 30064187 0 X WWW.ALLINAHEALTH.ORG/GIVE X 2010 MN THE ALLINA HEALTH FOUNDATION IS DEDICATED TO RAISING PHILANTHROPIC SUPPORT TO ADVANCE THE MISSION OF ALLINA HEALTH TO SERVE OUR COMMUNITIES BY PROVIDING EXCEPTIONAL CARE, AS WE PREVENT ILLNESS, RESTORE HEALTH AND PROVIDE COMFORT TO ALL WHO ENTRUST US WITH THEIR CARE. 11 10 0 70 0 0 3370299 18622693 0 0 185321 10816504 3722 0 3559342 29439197 2996654 9351820 0 0 0 0 0 0 0 749201 66261 3745855 9418081 -186513 20021116 11927149 229483214 916401 2163865 11010748 227319349 X THE ALLINA HEALTH FOUNDATION IS DEDICATED TO RAISING PHILANTHROPIC SUPPORT TO ADVANCE THE MISSION OF ALLINA HEALTH TO SERVE OUR COMMUNITIES BY PROVIDING EXCEPTIONAL CARE, AS WE PREVENT ILLNESS, RESTORE HEALTH AND PROVIDE COMFORT TO ALL WHO ENTRUST US WITH THEIR CARE. THE ALLINA HEALTH FOUNDATION WAS ESTABLISHED IN APRIL 2022 THROUGH THE COMING TOGETHER OF SEPARATE ALLINA HEALTH HOSPITAL AND SERVICE-SPECIFIC FOUNDATIONS TO BETTER SUPPORT ALLINA HEALTH IN PROVIDING A SEAMLESS CARE DELIVERY EXPERIENCE TO OUR PATIENTS AND COMMUNITIES. 0 0 7340476 7340476 0 PATIENT PROGRAMS, SERVICES, AND CLINICAL EDUCATION:OPERATIONAL GRANTS TO SUPPORT PROGRAMS INCLUDING CONTINUING EDUCATION, INTEGRATIVE MUSIC AND MASSAGE THERAPY, AND PATIENT CARE PROGRAMS ACROSS ALLINA HEALTH. EMERGENCY FINANCIAL ASSISTANCE FOR QUALIFYING CANCER PATIENTS TO HELP WITH EVERYDAY EXPENSES. 1091846 1091846 0 CONSTRUCTION AND MEDICAL EQUIPMENT:FUNDING FOR THE SURGICAL ONCOLOGY CENTER ROBOTIC LEASE AT UNITED HOSPITAL. FUNDING FOR THE TOTAL JOINT REPLACEMENT CAPITAL CAMPAIGN AT UNITED HOSPITAL. FUNDING FOR BREAST CANCER SPECIMEN IMAGER AT NEW ULM MEDICAL CENTER. 541955 541955 0 RESEARCH:A CLINICAL STUDY TO EXAMINE THE OUTCOMES OF A NEW OUTPATIENT CERVICAL RIPENING PROGRAM AT ALLINA MOTHER BABY CENTERS. A PHARMACY-DRIVEN PENICILLIN ALLERGY DE-LABELING PILOT PROGRAM IN PRE-OPERATIVE CORONARY ARTERY BYPASS GRAFT SURGERY AND SPINE SURGERY PATIENTS. COMPLEX MEMORY CARE, MOVEMENT DISORDERS, AND DEEP BRAIN STIMULATION. 377543 377543 0 CARING FOR COLLEAGUES:FUNDS TO PROVIDE EMERGENCY FINANCIAL ASSISTANCE TO EMPLOYEES OF ALLINA HEALTH WHO FACED UNEXPECTED AND SEVERE FINANCIAL STRAIN DUE TO CRISIS EVENT. 377543 377543 0 9351820 1 1 0 0 0 1 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 X 11 10 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN WI X TAX SERVICES 6122620660 2925 CHICAGO AVENUE MR 10890 MINNEAPOLIS MN 554071321 STEPHEN LACROIX DIRECTOR/CHAIR 2.00 2.00 X X 0 12500 0 ANDY KRANE DIRECTOR 2.00 0.00 X 0 0 0 CYNDI LESHER DIRECTOR 2.00 0.00 X 0 0 0 CHARLIE MONTREUIL DIRECTOR 2.00 0.00 X 0 0 0 CHRIS MORRISON DIRECTOR/VICE CHAIR (PART-YEAR) 2.00 0.00 X X 0 0 0 RON POOLE DIRECTOR 2.00 0.00 X 0 0 0 BART ZIBROWSKI DIRECTOR/VICE CHAIR (PART-YEAR) 2.00 0.00 X X 0 0 0 BARBARA BUTTS WILLIAMS DIRECTOR 2.00 0.00 X 0 10000 0 LINDA KETOVER MD DIRECTOR 2.00 0.00 X 0 20000 0 BRUCE ZEILINGER DIRECTOR 2.00 0.00 X 0 0 0 STEPHANIE LAITALA DIRECTOR 2.00 0.00 X 0 0 0 RICHARD MAGNUSON CFO 2.00 40.00 X 0 1371096 118831 TROY LINDLOFF ALLINA HEALTH VICE PRESIDENT 2.00 40.00 X 0 393747 28504 STEPHEN BARITEAU FORMER DIRECTOR/PRESIDENT 0.00 0.00 X 0 96097 0 0 1903440 147335 0 1 1 0 0 18622693 304167 18622693 3440536 3440536 8000958 624990 7375968 7375968 7375968 29439197 0 0 10816504 8197820 8197820 1154000 1154000 66261 66261 9418081 9351820 66261 0 178089 8022512 11585028 215133435 164032 6327267 11927149 229483214 916401 2163865 916401 2163865 X 5717776 41185067 5292972 186134282 11010748 227319349 11927149 229483214 X 20021116 -21022669 217310154 X X 0 1 X 1 0 X 3613479 3389858 5536477 3370299 18622693 34532806 3613479 3389858 5536477 3370299 18622693 34532806 4789590 29743216 176761 215874 212666 205803 3440536 4251640 35316 44694 38834 20198 139042 38923488 0.76410 0.92470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6 111027 99918 469113 1 1 1147774 116408209 -7061318 2679868 107814797 0.01190 0.52100 0.46710 0 0 0 EQUITY 73152346 F FIXED INCOME 78944488 F OTHER INVESTMENTS REAL RETURN MUTUAL FUNDS 4163888 F INVESTMENTS ACCOUNTED FOR A NET ASSET VALUE 38257020 F MONEY MARKET FUND 20615693 F 215133435 CHARITABLE REMAINDER TRUSTS BENEFICIARIES PAYABLE 1788747 DUE TO ALLINA HEALTH SYSTEM 375118 2163865 X 230708720 -21022669 5048299 217310154 201335784 29372936 66261 66261 29439197 14400119 5048299 5048299 9351820 66261 66261 9418081 PART X, LINE 2: ALLINA HEALTH FOUNDATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IT IS CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THEREFORE, CHARITABLE CONTRIBUTIONS ARE TAX DEDUCTIBLE. THE FOUNDATION HAS ADOPTED GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION OF UNCERTAIN TAX POSITIONS. THE GUIDANCE PRESCRIBES RECOGNITION THRESHOLD PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX FILING THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THIS GUIDANCE HAD NO IMPACT ON THE FOUNDATION'S FINANCIAL STATEMENTS. THE FOUNDATION'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE FOUNDATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. THE FOUNDATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -405,092. FUND BALANCE RECEIVED IN 4/1/22 MERGER 217,715,246. 1 ALLINA HEALTH SYSTEM 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)(3) 4874641 0 OPERATIONAL GRANTS TO SUPPORT PROGRAMS INCLUDING CONTINUING EDUCATION, INTEGRATIVE MUSIC AND MASSAGE THERAPY, AND PATIENT CARE PROGRAMS ACROSS ALLINA HEALTH SYSTEM ALLINA HEALTH SYSTEM 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)(3) 2266167 0 EMERGENCY FINANCIAL ASSISTANCE FOR QUALIFYING CANCER PATIENTS TO HELP WITH EVERYDAY EXPENSES ALLINA HEALTH SYSTEM 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)(3) 727896 0 FUNDING FOR THE SURGICAL ONCOLOGY CENTER ROBOTIC LEASE AND FUNDING FOR THE TOTAL JOINT REPLACEMENT CAPITAL CAMPAIGN AT UNITED HOSPITAL. ALLINA HEALTH SYSTEM 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)(3) 329116 0 FUNDING FOR BREAST CANCER SPECIMEN IMAGING AT NEW ULM MEDICAL CENTER 1 0 CARING FOR COLLEAGUES EMERGENCY FUND 220 377543 0 RESEARCH AND EDUCATION 37 541955 0 SCHOLARSHIPS AND AWARDS 24 234502 0 PART I, LINE 2: ALLINA HEALTH FOUNDATION STRICTLY MONITORS GRANT FUNDS TO ENSURE THAT SUCH GRANTS ARE USED FOR PROPER AND INTENDED PURPOSES AND ARE NOT OTHERWISE DIVERTED FROM THE INTENDED USE. THE ORGANIZATION HAS A PROCESS THAT INCLUDES A WRITTEN APPLICATION REQUIRING SUPPORTING DOCUMENTATION AND SUBSTANTIATION PRIOR TO A GRANT BEING APPROVED AND DISBURSED. IN ADDITION AND DEPENDING ON THE FACTS AND CIRCUMSTANCE OF THE GRANT, THE ORGANIZATION EMPLOYS VARIOUS METHODS TO ENSURE PROPER AND INTENDED USE SUCH AS: PERIODIC REPORTING TO THE ORGANIZATION, FIELD INVESTIGATIONS, CONTRACTS WITH REPAYMENT CLAUSES, REQUIRING ADDITIONAL SUBSTANTIATION AND DOCUMENTATION NOT AVAILABLE AT THE TIME OF THE GRANT, PAYING THIRD PARTIES DIRECTLY ON BEHALF OF THE GRANTEE ORGANIZATION, AND OTHER METHODS AS APPROPRIATE AND WARRANTED. X 1 1 1 1 0 0 0 0 1 0 1 1 RICHARD MAGNUSON CFO 0 817342 0 427877 0 125877 0 99021 0 19810 0 1489927 0 73910 TROY LINDLOFF ALLINA HEALTH VICE PRESIDENT 0 238139 0 50000 0 105608 0 5336 0 23168 0 422251 0 0 STEPHEN BARITEAU FORMER DIRECTOR/PRESIDENT 0 0 0 37862 0 58235 0 0 0 0 0 96097 0 0 PART I, LINE 1B TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ALLINA HEALTH SYSTEM PROVIDES THIS TYPE OF PAYMENT AS IT RELATES TO EXPENSE REIMBURSEMENTS ON CERTAIN EXECUTIVES. TROY LINDLOFF - $82,731 PART I, LINE 3 THE ORGANIZATION RELIED ON ALLINA HEALTH SYSTEM, A RELATED ORGANIZATION, WHEN SETTING REASONABLE COMPENSATION OF THE OFFICERS. ALINNA HEALTH SYSTEM USES THE FOLLOWING WHEN DETERMINING COMPENSATION FOR OFFICERS AND EMPLOYEES: (1) COMPENSATION COMMITTEE, (2) INDEPENDENT COMPENSATION CONSULTANT, (3) WRITTEN EMPLOYMENT CONTRACT, (4) COMPENSATION SURVEY OR STUDY, AND (5) APPROVAL BY BOARD OF DIRECTORS OR COMPENSATION COMMITTEE. PART I, LINES 4A-B LINE 4(A): STEPHEN BARITEAU - $58,234 LINE 4(B): RICHARD MAGNUSON - $96,521 PART I, LINE 6 DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: ALLINA INCENTIVE PLAN ALLINA PROVIDES AN ANNUAL INCENTIVE COMPENSATION OPPORTUNITY FOR EXECUTIVES, MANAGEMENT AND KEY INDIVIDUAL CONTRIBUTOR STAFF. UNDER THIS PLAN, THE TARGET AWARD IS EXPRESSED AS A FUNCTION OF THE PARTICIPANT'S SALARY PAID DURING THE CALENDAR YEAR AND REQUIRES AT LEAST FOUR MONTHS OF SERVICE IN AN ELIGIBLE POSITION DURING THE YEAR. ACTUAL AWARDS CAN RANGE FROM 0% TO 150% OF THE TARGET AWARD, BASED ON ALLINA'S FINANCIAL AND NON-FINANCIAL PERFORMANCE OVER THE CALENDAR YEAR. NON-FINANCIAL PERFORMANCE MEASURES INCLUDE PATIENT & EMPLOYEE SAFETY, QUALITY, PATIENT EXPERIENCE AND FINANCIAL HEALTH. NO AWARDS ARE PROVIDED UNLESS THRESHOLD FINANCIAL PERFORMANCE IS ACHIEVED. PARTICIPANTS WHO HAVE LEFT EMPLOYMENT PRIOR TO THE END OF THE YEAR AS THE RESULT OF VOLUNTARY TERMINATION OR TERMINATION FOR POOR PERFORMANCE ARE NOT ELIGIBLE FOR AN AWARD. LONG-TERM INCENTIVE PLAN (LTIP) ALLINA HAS A LONG-TERM INCENTIVE PLAN THAT PROVIDES A CASH AWARD OPPORTUNITY TO A SMALL NUMBER OF TOP EXECUTIVES APPROVED FOR PARTICIPATION BY THE HUMAN RESOURCES & COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF ALLINA HEALTH ("THE COMMITTEE"). THE AWARD OPPORTUNITY IS BASED ON ALLINA PERFORMANCE DURING OVERLAPPING THREE-YEAR CYCLES. PERFORMANCE MEASURES AND TARGETS ARE DEFINED BY THE COMMITTEE FOR EACH THREE-YEAR PERIOD AND CAN VARY FROM ONE PERIOD TO ANOTHER DEPENDING ON THE COMMITTEE'S JUDGMENT OF THE MOST IMPORTANT MEASURES OF SUCCESS. AWARDS CAN RANGE FROM 0% TO 150% OF TARGET AWARDS. PART I, LINE 8 CERTAIN AMOUNTS REPORTED ON FORM 990, PART VII WERE PAID OR ACCRUED PURSUANT TO A CONTRACT THAT WAS SUBJECT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGULATION SECTION 53.4958-4(A)(3). FROM TIME TO TIME, ALLINA HEALTH SYSTEM ENTERS INTO CONTRACTUAL ARRANGEMENTS THAT MAY QUALIFY FOR THE INITIAL CONTRACT EXCEPTION BASED ON THE TERMS AND UNDERSTANDINGS OF THE CONTRACTUAL AGREEMENTS. SCHEDULE J, LINE 4(A) & (B) ADDITIONAL COMPENSATION DISCLOSURE: DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: EXECUTIVE MUTUAL FUND ACCOUNT PLAN PHYSICIAN MUTUAL FUND ACCOUNT PLAN THESE ACCOUNTS GIVE THE PARTICIPANT THE OPPORTUNITY FOR CAPITAL ACCUMULATION NOT FULLY AVAILABLE TO THEM THROUGH SOCIAL SECURITY OR THE GENERAL EMPLOYEE RETIREMENT PLANS BECAUSE OF MAXIMUMS PLACED ON COMPENSATION THAT CAN BE RECOGNIZED UNDER FEDERAL LAW FOR PURPOSES OF CONTRIBUTIONS. THEY ALSO SERVE AS AN IMPORTANT NON-COMPETE INCENTIVE TO PARTICIPANTS. PRIOR TO THE YEAR IN WHICH CONTRIBUTIONS ARE MADE, THE PARTICIPANT MUST DESIGNATE A VESTING/PAYOUT DATE CONSISTENT WITH THE CONSTRAINTS OF THE PLANS AND FEDERAL DEFERRED COMPENSATION REGULATIONS. AFTER THE CONTRIBUTIONS ARE MADE, THE PARTICIPANT HAS A ONE-TIME LIMITED OPPORTUNITY TO EXTEND THE ELECTED PAYMENT DATE FOR AT LEAST FIVE YEARS. ONCE THE VESTING/PAYOUT DATE HAS BEEN REACHED, ALLINA WILL WITHHOLD THE APPROPRIATE TAXES AND THE BALANCE WILL BE PAID TO THE PARTICIPANT ON THEIR PAYCHECK AS SOON AS ADMINISTRATIVELY FEASIBLE. IF THE PARTICIPANT TERMINATES EMPLOYMENT VOLUNTARILY BEFORE AN AMOUNT IS PAID, PAYMENT WILL BE SUBJECT TO THE PARTICIPANT'S COMPLIANCE WITH A NON-COMPETE AGREEMENT WITH ALLINA FOR TWO YEARS AFTER TERMINATION. THE PARTICIPANT MAY ELECT FROM AMONG INVESTMENT ALTERNATIVES THAT ARE SIMILAR TO THOSE AVAILABLE IN THE RETIREMENT SAVINGS PLAN. UNLIKE THE RETIREMENT SAVINGS PLAN, THE PARTICIPANT HAS THE STATUS OF AN UNSECURED CREDITOR OF ALLINA AND WILL NOT HAVE A PREFERRED CLAIM TO PAYMENT IN THE CASE OF THE COMPANY'S INABILITY TO PAY. HOWEVER, THE COMPANY DOES SET ASIDE ASSETS FOR ITS OBLIGATIONS BY ACTUALLY INVESTING THE PROMISED ASSETS CONSISTENT WITH PARTICIPANT ELECTIONS. ALLINA DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THIS PLAN WAS AMENDED AND FROZEN EFFECTIVE DECEMBER 31, 2008, SUCH THAT NO FUTURE BENEFITS ACCRUE FOR SERVICE AFTER THAT DATE. THIS PLAN WAS REPLACED WITH THE EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN (ERBRP) EFFECTIVE JANUARY 1, 2009, AND IS NOW FROZEN AS OF DECEMBER 31, 2018. ELIGIBLE ALLINA EXECUTIVES PARTICIPATED IN A DEFINED CONTRIBUTION SERP. EMPLOYER CREDITS WERE MADE EACH YEAR TO THEIR DC SERP BALANCE ACCORDING TO THE FOLLOWING SCHEDULE: EXEC YRS OF SERVICE CONTRIBUTION % OF PENSIONABLE EARNINGS 0-5 2.75% 6-10 3.50% 11+ 4.75% EXECUTIVES WERE ALSO CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE PENSION ACCOUNT PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE PENSION ACCOUNT PLAN CREDITING RATE AS DECLARED BY ALLINA. THE CURRENT RATE IS 4%. THE PARTICIPANT VESTS AFTER THREE YEARS OF EXECUTIVE SERVICE PROVIDED THAT IF THE PARTICIPANT TERMINATES EMPLOYMENT WITH ALLINA PRIOR TO AGE 65 FOR ANY REASON OTHER THAN ELIMINATION OF POSITION, THE PARTICIPANT MUST FULFILL THE TERMS OF A COVENANT NOT TO COMPETE, BENEFITS ARE PAID AS A SINGLE LUMP-SUM AMOUNT UPON AGE 65, RETIREMENT OR JOB POSITION ELIMINATION. IN THE CASE OF OTHER VOLUNTARY TERMINATIONS, PAYMENT IS DELAYED UNTIL COMPLETION OF THE TWO-YEAR NON-COMPETE PERIOD. THE DC SERP IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. ALLINA EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN ELIGIBLE ALLINA EXECUTIVES PARTICIPATE IN A DEFERRED COMPENSATION RETIREMENT PLAN. EXECUTIVES ARE CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE ALLINA RETIREMENT SAVINGS PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. EMPLOYER CREDITS ARE MADE EACH YEAR TO THEIR ACCOUNT BALANCE ACCORDING TO THE FOLLOWING SCHEDULE AS OF THE END OF THE PLAN YEAR: PARTICIPANT'S YEARS OF VESTING SERVICE APPLICABLE PERCENTAGE LESS THAN 1 0% 1-5 5.0% 6-10 5.5% 11-15 6.0% 16 OR MORE 6.5% DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE INVESTMENT OPTIONS SELECTED BY THE PARTICIPANT WHICH ARE THE SAME OPTIONS AVAILABLE UNDER THE QUALIFIED PLAN. A PARTICIPANT WHO HAS COMPLETED AT LEAST TWO YEARS OF SERVICE BECOMES VESTED IN THE PORTION OF HIS OR HER ACCOUNT ATTRIBUTABLE TO THE ANNUAL CREDIT FOR A PARTICULAR YEAR AS OF JANUARY 15 OF THE YEAR FOLLOWING THE CALENDAR YEAR IN WHICH THE ANNUAL CREDIT IS EARNED. IN THE EVENT OF TERMINATION (OTHER THAN BECAUSE OF DEATH) PRIOR TO AGE 67, THE DISTRIBUTION DATE SHALL BE AS SOON AS ADMINISTRATIVELY POSSIBLE AFTER TERMINATION IN THE FORM OF A LUMP SUM PAYMENT. THE PLAN IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. THIS PLAN WAS EFFECTIVE JANUARY 1, 2009 AND IS NOW FROZEN AS OF DECEMBER 31, 2018. EXECUTIVE SEVERANCE PLAN ALLINA PROVIDES SALARY CONTINUATION FOR EXECUTIVES WHO'S EMPLOYMENT HAS BEEN INVOLUNTARILY TERMINATED FOR REASONS OTHER THAN CAUSE OR POOR PERFORMANCE. THE LENGTH OF THE SEVERANCE PAY PERIOD IS DEFINED BY THE PLAN AND DEPENDS ON THE LEVEL OF THE EXECUTIVE POSITION. UNDER THE PLAN THE SEVERED EXECUTIVE ALSO COULD CONTINUE CERTAIN BENEFITS FOR A LIMITED PERIOD OF TIME. IN 2009 THE PLAN WAS AMENDED TO FURTHER RESTRICT SEVERANCE BENEFITS IN THE CASE THAT THE EXECUTIVE OBTAINS OTHER EMPLOYMENT DURING THE SEVERANCE PERIOD. SUPPLEMENTAL PHYSICIAN AND EXECUTIVE SAVINGS PLAN THIS PLAN'S PURPOSE IS TO PROVIDE A SELECT GROUP OF PHYSICIANS AND EXECUTIVES WITH ADDITIONAL DEFERRED COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INTENDED TO BE EXEMPT FROM CODE SECTION 409A AND 457(F). ANNUAL CONTRIBUTIONS ARE MADE EACH FEBRUARY AND ARE BASED ON PREVIOUS YEAR'S ELIGIBLE COMPENSATION. PARTICIPANT'S APPLICABLE CONTRIBUTION PERCENTAGE FOLLOWS: PARTICIPANT APPLICABLE PERCENTAGE PHYSICIANS 5% VP'S 12% SVP | EVP 15% CEO 20% OF BASE SALARY + 10% OF BASE SALARY OVER IRS PAY LIMIT IF PARTICIPANT IS FULLY VESTED, THE CONTRIBUTION IS PAID DIRECTLY TO PARTICIPANT, LESS TAXES IN LATE JANUARY. IF PARTICIPANT IS UNVESTED, THE CONTRIBUTION IS DEPOSITED WITH FIDELITY. THE VESTING SCHEDULE FOR THIS PLAN FOLLOWS: FOR 2019 CONTRIBUTION, ONLY - IT WAS DEPOSITED IN FEBRUARY 2020, 50% VESTING AFTER 2 YEARS - I.E. 2021, PAID OUT 01/2021; AND, 50% VESTING IN 2022, PAID OUT 01/2022. FOR 2020 CONTRIBUTIONS AND AFTER - VESTING OCCURS AFTER 3 YEARS - I.E. 2020 CONTRIBUTION VESTS IN 2023, THE 2021 CONTRIBUTION VESTS IN 2024, ETC. PARTICIPANTS ARE 100% VESTED AT THE EARLIER OF AT LEAST AGE 60 WITH 7 YEARS OF SERVICE OR AGE 65. GRANDFATHERED PROVISION - FOR THOSE AGE 54 OR OLDER AND EMPLOYED AS OF 12/31/2018: EARLIER OF AT LEAST AGE 60 WITH 3 YEARS OF SERVICE OR AGE 65. THIS PLAN WAS EFFECTIVE JANUARY 1, 2019. A NON-COMPETE CLAUSE DOES NOT APPLY TO THIS PLAN. X EQUIPMENT 106 240287 FMV X EYEGLASS FRAMES AND GLASSES 747 63880 FMV 0 0 1 0 PART I, COLUMN (B): THE NUMBER REPRESENTS THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS CAN ESTABLISH COMMITTEES WITH THE AUTHORITY OF THE BOARD OF DIRECTORS. THE MEMBERS AND CHAIR OF EACH COMMITTEE SHALL BE NOMINATED AND ELECTED BY THE BOARD OF DIRECTORS. EXCEPT AS OTHERWISE SPECIFIED, (A) THE CHAIR OF EACH COMMITTEE MUST BE A MEMBER OF THE BOARD OF DIRECTORS; AND (B) OTHER COMMITTEE MEMBERS SHALL NOT BE REQUIRED TO BE DIRECTORS OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 4 AS MORE FULLY DESCRIBED IN THE ARTICLES OF MERGER FILED BY ALLINA HEALTH SYSTEM WITH THE MINNESOTA SECRETARY OF STATE ON APRIL 1, 2022, FOUR SEPARATE MINNESOTA NONPROFIT CORPORATIONS THAT SUPPORTED DIFFERENT OPERATIONAL SEGMENTS OF ALLINA HEALTH SYSTEM WERE MERGED INTO A SINGLE UNIFIED ENTITY. EACH MERGED FOUNDATION ENTITY WAS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND THE RESULTING UNIFIED FOUNDATION CONTINUES TO BE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3). THIS CREATION OF A UNIFIED FOUNDATION TO SUPPORT THE MISSION OF ALLINA HEALTH SYSTEM AND THE PATIENTS AND COMMUNITIES THAT IT SERVES INVOLVED THE MERGER OF THE ABBOTT NORTHWESTERN HOSPITAL FOUNDATION, THE COURAGE KENNY FOUNDATION, THE MERCY AND UNITY HOSPITALS FOUNDATION, AND THE UNITED HOSPITAL FOUNDATION INTO THIS ENTITY ALLINA HEALTH FOUNDATION FORMERLY KNOWN AS THE ALLINA ASSOCIATED FOUNDATION. PURSUANT TO MINNESOTA STATUTES, SECTION 317A.811, SUBD. 6, THE MERGER WAS EFFECTIVE APRIL 1, 2022, AND ALL OF THE ASSETS AND LIABILITIES OF THE MERGED FOUNDATION BECAME THE ASSETS AND LIABILITIES OF THE ALLINA HEALTH FOUNDATION, THE SURVIVING AND SUCCESSOR FOUNDATION. ALL RESTRICTED ASSETS AND FUNDS TRANSFERRED IN THE MERGER RETAIN THE RESTRICTIONS IN THE HANDS OF THE NEW FOUNDATION TO COMPLY WITH THE SPECIFIC INTENT OF THE DONORS. AMENDED ARTICLES WERE ALSO FILED FOR THE ALLINA ASSOCIATED FOUNDATION TO REFLECT A NAME CHANGE EFFECTIVE MARCH 31, 2022 TO THE ALLINA HEALTH FOUNDATION. EACH OF THE FOUR FOUNDATIONS MERGED INTO THE ALLINA HEALTH FOUNDATION FILED FINAL IRS FORMS 990 FOR THE SHORT PERIOD JANUARY 1, 2022 TO APRIL 1, 2022. FORM 990, PART VI, SECTION A, LINE 6 PARENT ORGANIZATION ALLINA HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER ORGANIZATION OF ALLINA HEALTH FOUNDATION. SEE SCHEDULE R FOR FURTHER DETAILS. ALLINA HEALTH SYSTEM PROVIDES ALLINA HEALTH FOUNDATION WITH ADMINISTRATIVE AND STAFF SERVICES AT NO COST. THE VALUE OF THE SERVICES PROVIDED BY ALLINA HEALTH SYSTEM TO ALLINA HEALTH FOUNDATION DURING 2022 WERE ESTIMATED AT $5,048,299 AND HAVE BEEN RECORDED ON THE AUDITED FINANCIAL STATEMENTS AS CONTRIBUTION REVENUE FROM A RELATED ORGANIZATION IN THE STATEMENT OF REVENUE AND AS ADMINISTRATIVE AND FUNDRAISING EXPENSES IN THE STATEMENT OF FUNCTIONAL EXPENSES. NONFINANCIAL CONTRIBUTIONS THAT ARE DONATED SERVICES ARE NOT INCLUDED IN THE STATEMENT OF REVENUE OR STATEMENT OF FUNCTIONAL EXPENSES ON THE FORM 990. AS SUCH, NONFINANCIAL CONTRIBUTIONS THAT ARE SERVICES WITHIN NOTE 9 OF THE AUDITED FINANCIAL STATEMENTS THAT TOTAL $5,048,299 ARE RECONCILED ON SCHEDULE D, PART XI AND PART XII AS DONATED SERVICES AND USE OF FACILITIES. ALLINA HEALTH FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. COMPENSATION DISCLOSED AS PAID BY A RELATED ORGANIZATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE CORPORATE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM HOLDS CERTAIN RESERVED POWERS OVER ALLINA HEALTH FOUNDATION. RESERVED POWERS BY ALLINA HEALTH FOUNDATION INCLUDE SUCH POWERS AS ELECTION AND APPROVAL OF DIRECTORS. UNDER THE BYLAWS, DIRECTORS OF THE ALLINA HEALTH FOUNDATION ARE REQUIRED TO BE MEMBERS OF THE PHILANTHROPY COMMITTEE OF THE ALLINA HEALTH SYSTEM BOARD OF DIRECTORS (THE "PHILANTHROPY COMMITTEE"). ANY PROPOSED CHANGES TO THE MEMBERSHIP OF THE PHILANTHROPY COMMITTEE ARE SIMULTANEOUSLY PRESENTED TO THE BOARD OF THE ALLINA HEALTH FOUNDATION, AND THE BOARD OF THE ALLINA HEALTH FOUNDATION IS REQUIRED TO APPROVE ANY ADJUSTMENTS TO ITS BOARD MEMBERSHIP TO ENSURE THAT THE MEMBERS MIRROR THE MEMBERS OF THE PHILANTHROPY COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE CORPORATE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM HOLDS CERTAIN RESERVED POWERS OVER ALLINA HEALTH FOUNDATION. THE RESERVED POWERS INCLUDE SUCH POWERS AS FINAL APPROVAL OF AMENDMENTS TO ARTICLES OF INCORPORATION OR BYLAWS, APPROVAL OF STRATEGIC PLANS AND CAPITAL AND OPERATING BUDGETS, APPROVAL OF PLANS OF MERGER OR CONSOLIDATION, APPROVAL OF INCURRENCE OF DEBT OR EXPENDITURES IN EXCESS OF CERTAIN AMOUNTS, AND VARIOUS OTHER RESERVED POWERS AS DESCRIBED THEREIN. FORM 990, PART VI, SECTION B, LINE 11B ALLINA HEALTH FOUNDATION'S FORM 990 WAS PREPARED EXTERNALLY BY THE FOUNDATION'S PUBLIC ACCOUNTING FIRM. THE FORM 990 WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA HEALTH SYSTEM, ALLINA HEALTH FOUNDATION'S SOLE CORPORATE MEMBER TAX MANAGER AND TAX DIRECTOR. ALLINA'S CHIEF FINANCIAL OFFICER ALSO PERFORMED AN EXECUTIVE REVIEW OF THE FORM 990. AFTER THE MANAGEMENT REVIEW PROCESS DESCRIBED ABOVE WAS COMPLETED, THE FINAL FORM 990, AS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE ["IRS"], WAS PROVIDED TO EACH VOTING MEMBER OF ALLINA HEALTH FOUNDATION'S BOARD OF DIRECTORS. ALLINA HEALTH FOUNDATION'S BOARD OF DIRECTORS VOTED ON AND APPROVED A RESOLUTION APPROVING THE FORM 990, THE MINNESOTA CHARITABLE ORGANIZATION ANNUAL REPORT TO BE FILED WITH THE MINNESOTA ATTORNEY GENERAL, AND THE WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT TO BE FILED WITH THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTIONS. THE BOARD OF DIRECTORS RESOLUTION ALSO DIRECTED OFFICERS TO FILE THE FORM 990 WITH THE IRS, THE CHARITABLE ANNUAL REPORT WITH THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL, AND THE WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTIONS. THE ABOVE STATED REVIEW AND APPROVAL PROCESS OCCURRED PRIOR TO FILING ALLINA HEALTH FOUNDATION'S FORM 990 WITH THE IRS, MINNESOTA CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE MINNESOTA ATTORNEY GENERAL, AND WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE WISCONSIN DEPARTMENT FINANCIAL INSTITUTIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS SEVERAL METHODS OF MONITORING AND ENFORCING COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. FIRST, THE ORGANIZATION REGULARLY DISTRIBUTES CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRES TO ITS OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES. THESE INDIVIDUALS ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS, INCLUDING ANY FAMILY OR BUSINESS RELATIONSHIP. SECOND, THE GENERAL COUNSEL'S OFFICE ANNUALLY DELIVERS A REPORT TO ALLINA'S BOARD OF DIRECTORS WHICH INCLUDES, AMONG OTHER THINGS, THE RESULTS OF THE CONFLICT OF INTEREST QUESTIONNAIRE, AN ANALYSIS OF POTENTIAL CONFLICTS, AND GUIDANCE FOR SATISFACTORILY RESOLVING CONFLICTS. THIRD, THE ORGANIZATION UNDERTAKES MANDATORY COMPLIANCE TRAINING OF ALL ITS EMPLOYEES WHICH INCLUDES TRAINING ON CONFLICTS OF INTEREST. FOURTH, ALL EMPLOYEES RECEIVE, AND ARE EXPECTED TO CONDUCT THEMSELVES IN ACCORDANCE WITH ALLINA'S CODE OF CONDUCT. THE CODE OF CONDUCT CONTAINS EDUCATIONAL MATERIALS AND GUIDANCE TO RESOLVE POTENTIAL CONFLICTS OF INTEREST. FIFTH, ALLINA MAINTAINS A CORPORATE INTEGRITY HOTLINE, A CONFIDENTIAL 24 HOUR EXTERNAL RESOURCE TO HELP ANSWER QUESTIONS RELATED TO ETHICAL BUSINESS CONDUCT. ALL CALLS TO THE INTEGRITY LINE ARE KEPT CONFIDENTIAL. FORM 990, PART VI, SECTION B, LINE 15 ALLINA HEALTH FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ANY COMPENSATION DISCLOSED AS PAID BY A RELATED ORGANIZATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATION. THEREFORE, PART VI, SECTION B, LINE 15A AND LINE 15B ARE NOT APPLICABLE TO ALLINA HEALTH FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 ALLINA HEALTH FOUNDATION MAKES ITS FORM 990, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. TO ARRANGE AN INSPECTION OR RECEIVE A COPY, PLEASE CONTACT THE FOLLOWING: ALLINA HEALTH FOUNDATION TAX SERVICES MAIL ROUTE 10890 P.O. BOX 43 MINNEAPOLIS, MN 55407-0043 TELEPHONE: 612-262-0660 PHYSICAL ADDRESS: 2925 CHICAGO AVENUE MINNEAPOLIS, MN 55407-1321 THE FORM 990 AND FORM 1023 ARE ALSO AVAILABLE DIRECTLY FROM THE INTERNAL REVENUE SERVICE. THE FORM 990 AND FINANCIAL STATEMENTS ARE ALSO AVAILABLE FROM THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -405,092. FUND BALANCE RECEIVED IN 4/1/22 MERGER 217,715,246. FORM 990, PART XII, LINE 2C: THIS PROCESS REMAINS UNCHANGED FROM THE PRIOR YEAR. 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