2022-08-12T08:27:21-05:00 2021-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2020-10-01 411677288 LAKE REGION HEALTHCARE FOUNDATION LAKE 2187368000 712 S CASCADE ST FERGUS FALLS MN 56537 DIC PICKETT SECRETARY 2187368000 2022-08-11 1 DIC PICKETT 999009999 DARRYN MCGARVEY P00958683 6123764500 2022-08-01 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z KENT MATTSON 712 S CASCADE ST FERGUS FALLS MN 56537 1609096 0 X X 2000 MN THE MISSION OF LAKE REGION HEALTHCARE FOUNDATION IS TO GATHER, STEWARD AND DISTRIBUTE RESOURCES NEEDED TO SUPPORT AND ADVANCE THE MISSION OF LAKE REGION HEALTHCARE AND ITS AFFILIATES. 16 15 0 23 0 0 176887 1004283 0 0 390387 -10552 27526 -3819 594800 989912 153535 33724 0 0 0 0 0 0 0 16858 96811 170393 130535 424407 859377 12270378 13800860 8172450 8162400 4097928 5638460 WE PARTNER TO ENRICH LIFE THROUGH HEALTH 0 0 118799 33724 LAKE REGION HEALTHCARE FOUNDATION RECEIVED DONATIONS AND MEMORIALS FROM INDIVIDUALS AND BUSINESSES. IT ALSO RECEIVES PLEDGES AND PAYMENTS OF THOSE PLEDGES. THE FOUNDATION USES IT'S FUNDS FOR A VARIETY OF PURPOSES WHICH AID LAKE REGION HEALTHCARE AND THE COMMUNITY IN PROVIDING QUALITY HEALTHCARE. 118799 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 0 0 MN X X LAKE REGION HEALTHCARE CORPORATION 2187368000 712 S CASCADE ST FERGUS FALLS MN 56537 KENT MATTSON CEO 1.00 40.00 X X 0 434466 50008 JOHN ERICKSON DIRECTOR 2.00 9.00 X 0 0 0 LAUREL NELSON DIRECTOR 2.00 6.00 X 0 0 0 CARRIE BRIMHALL DIRECTOR 2.00 5.00 X 0 0 0 DEBRA FERGUSON DIRECTOR 2.00 5.00 X 0 0 0 JERRY NESS DIRECTOR 2.00 4.00 X 0 0 0 ANDREW YAGGIE DIRECTOR/CHAIR 2.00 0.00 X X 0 0 0 CEDAR WALTERS DIRECTOR 2.00 0.00 X 0 0 0 SCOTT DEBRITO DIRECTOR 2.00 0.00 X 0 0 0 DIC PICKETT DIRECTOR/SECRETARY & TREASURER 2.00 0.00 X X 0 0 0 JOAN GEDDE DIRECTOR 2.00 0.00 X 0 0 0 JASMINE SONMOR DIRECTOR 2.00 0.00 X 0 0 0 MARK HELLAND DIRECTOR 2.00 0.00 X 0 0 0 CRYSTAL ADAMS DIRECTOR 2.00 0.00 X 0 0 0 STEVE RUFER DIRECTOR 2.00 0.00 X 0 0 0 GARY SPIES DIRECTOR 2.00 0.00 X 0 0 0 KYLE RICHARDS FORMER CEO 0.00 0.00 X 0 367500 0 0 801966 50008 0 1 1 0 0 91217 913066 1004283 20785 20785 584028 615365 -31337 -31337 -31337 0 91217 3819 -3819 -3819 989912 0 0 -14371 33724 33724 3300 3300 2104 2104 257 257 MISCELLANEOUS PURCHASED 63318 56986 6332 OTHER FUNDRAISING EXPEN 11888 11888 SERVICE CHARGES 11694 11694 MEALS 4080 4080 170 170 130535 118799 11736 0 385025 1046309 70164 57664 6802 8162400 8162400 1000 1867 3644987 4528653 0 3967 12270378 13800860 10050 8162400 8162400 8172450 8162400 X 2618974 3220028 1478954 2418432 4097928 5638460 12270378 13800860 X 859377 793310 -112155 X 0 1 X 1 0 X X X 1 LAKE REGION HEALTHCARE CORPORATION 410730602 3 1 219000 0 1 219000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 36 1030018 90490 2373230 1 1 0 X 1674886 793310 -112155 681155 993731 -3819 -3819 989912 134354 3819 3819 130535 0 130535 PART XI, LINE 2D - OTHER ADJUSTMENTS: INTERCOMPANY TRANSFERS: -255,123 AUDIT ADJUSTMENT: 142,968 PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENTS: -3819 PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENTS: 3819 SCHEDULE D, PART X, LINE 2 THE FOUNDATION IS ORGANIZED AS A MINNESOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE FOUNDATION IS REQUIRED ANNUALLY TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE FOUNDATION MAY BE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE FOUNDATION HAS DETERMINED THEY ARE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED FORM 990T WITH THE IRS. THE FOUNDATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE FOUNDATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE, IF SUCH INTEREST AND PENALTIES ARE INCURRED. GIVING HEARTS DAY 45900 45900 795 GALA 45317 45317 3024 91217 91217 3024 795 3819 -3819 1 0 0 0 0 0 1 0 0 KENT MATTSON CEO 0 460000 0 0 0 -25534 0 20500 0 29508 0 484474 0 0 KYLE RICHARDS FORMER CEO 0 0 0 0 0 367500 0 0 0 0 0 367500 0 0 PART I, LINE 4A KYLE RICHARDS RECEIVED $367,500 IN SEVERANCE PAY. PART I, LINE 5 LRHC HAS IMPLEMENTED AN INCENTIVE COMPENSATION PROGRAM FOR CERTAIN EXECUTIVE LEADERSHIP POSITIONS WITHIN THE ORGANIZATION. CERTAIN MEASURES AND GOALS NEED TO BE MET IN ORDER FOR THE COMPENSATION TO BE PAID OUT IN PART OR IN WHOLE, SUCH AS MEETING FINANCIAL PERFORMANCE EXPECTATIONS, QUALITY METRICS, AND SUCCESSFUL IMPLEMENTATION OF STRATEGIC GOALS. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS PERFORMANCE ANNUALLY AND DETERMINES ANY AMOUNTS OF COMPENSATION THAT IS AWARDED. FORM 990, PART VI, SECTION A, LINE 6 LAKE REGION HEALTHCARE IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF LAKE REGION HEALTHCARE, THE SUPPORTED ORGANIZATION, HAS THE AUTHORITY TO APPOINT AND REMOVE THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF TRUSTEES OF LAKE REGION HEALTHCARE, THE SUPPORTED ORGANIZATION, HAS THE AUTHORITY TO MAKE AND APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE COMPLETED 990, WITH SUPPORTING SCHEDULES AND FOOTNOTES, WILL BE DISTRIBUTED TO ALL THE FOUNDATION BOARD MEMBERS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE DETAILED AND CONSCIENTIOUS REVIEW BY ALL BOARD MEMBERS AND CHIEF EXECUTIVE OFFICER TO ENABLE AN OPPORTUNITY FOR FEEDBACK FROM AND CORRECTIONS. ALL QUESTIONS, CONCERNS, OR OTHER FEEDBACK FROM BOARD MEMBERS WILL BE DIRECTED TO THE CHIEF FINANCIAL OFFICER AND INCORPORATED TO THE 990 AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND TRUSTEES ANNUALLY ASSESS WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST ACCORDING TO THE CONFLICTS OF INTEREST POLICY. IT IS CONSISTENTLY MONITORED DURING THE YEAR TO BE SURE THAT THE POLICY IS BEING FOLLOWED. FORM 990, PART VI, SECTION C, LINE 19 LAKE REGION HEALTHCARE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: RELATED COMPANY TRANSFER -255,123. OTHER CHANGES IN NET ASSETS 142,968. LAKE REGION HEALTHCARE CORPORATION 712 S CASCADE ST FERGUS FALLS MN 56537 410730602 HOSPITAL MN 501(C)(3) 3 N/A 0 LRHC LONG TERM CARE FACILITIES INC 712 S CASCADE ST FERGUS FALLS MN 56537 411817549 ASSISTED LIVING MN 501(C)(3) 10 LAKE REGION HEALTHCARE 0 PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES 1411 HIGHWAY 79 E ELBOW LAKE MN 56531 411763968 HEALTHCARE SERVICES MN 501(C)(3) 3 LAKE REGION HEALTHCARE 0 PRAIRIE RIDGE FOUNDATION 1411 HIGHWAY 79 E ELBOW LAKE MN 56531 455092280 FOUNDATION MN 501(C)(3) 12A LAKE REGION HEALTHCARE 0 LRH RAD ONC SERVICES 712 SOUTH CASCADE STREET FERGUS FALLS MN 56538 271322270 RADIATION AND ONCOLOGY MN N/A 0 0 LAKE REGION HOME MEDICAL SUPPLY 712 SOUTH CASCADE STREET FERGUS FALLS MN 56538 464182501 MEDICAL EQUIPMENT SALES MN N/A 0 0 WEST CENTRAL LINEN SERVICES 712 SOUTH CASCADE STREET FERGUS FALLS MN 56538 411411129 LAUNDRY AND LINEN MN N/A 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 LAKE REGION HEALTHCARE CORPORATION B 219000 FMV