2022-11-15T09:16:49-06:00 2021-12-31 990 2021-01-01 411952989 COURAGE KENNY FOUNDATION COUR 6122620660 P O BOX 43 INTERNAL ZIP 10890 MINNEAPOLIS MN 554400043 RICHARD E MAGNUSON CHIEF FINANCIAL OFFICER 6122620660 2022-11-14 RICHARD MAGNUSON 999009999 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z LINDA ORTNER P O BOX 43 INTERNAL ZIP 10890 MINNEAPOLIS MN 554400043 19560084 0 X WWW.ALLINAHEALTH.ORG/GIVE X 1999 MN TO RAISE FUNDS AND ENGAGE THE COMMUNITY TO SUPPORT HEALTH AND INDEPENDENCE FOR THOSE WITH FUNCTIONAL LIMITATIONS THROUGH COURAGE KENNY REHAB'S COMPREHENSIVE CONTINUUM OF TRANSFORMATIVE SERVICES, RESEARCH AND INNOVATION, AND PUBLIC ADVOCACY. WITH THE FOUNDATION'S SUPPORT, THE CONTINUUM ENRICHES LIVES AND PROVIDES A LEVEL OF CARE ABOVE AND BEYOND THE CORE MEDICAL SERVICES PROVIDED BY ALLINA HEALTH. 21 19 0 55 0 0 5697361 8003876 0 0 2555399 1154483 844401 -110416 9097161 9047943 4970699 4729921 0 0 0 0 0 0 462517 3121497 1587404 8092196 6317325 1004965 2730618 38134298 42769363 1076741 1073766 37057557 41695597 X TO RAISE FUNDS AND ENGAGE THE COMMUNITY TO SUPPORT HEALTH AND INDEPENDENCE FOR THOSE WITH FUNCTIONAL LIMITATIONS THROUGH COURAGE KENNY REHAB'S COMPREHENSIVE CONTINUUM OF TRANSFORMATIVE SERVICES, RESEARCH AND INNOVATION, AND PUBLIC ADVOCACY. WITH THE FOUNDATION'S SUPPORT, THE CONTINUUM ENRICHES LIVES AND PROVIDES A LEVEL OF CARE ABOVE AND BEYOND THE CORE MEDICAL SERVICES PROVIDED BY ALLINA HEALTH. 0 0 4557548 4557548 FUNDS FOR PROGRAMS, SERVICES, AND CAPITAL IMPROVEMENTS WERE APPROVED TOENHANCE THE COMPONENTS OF COURAGE KENNY REHABILITATION INSTITUTE'SREHABILITATIVE PROGRAM: OPTIMIZING PHYSICAL FUNCTION, MAXIMIZINGABILITIES OF DAILY LIVING AND LESSENING DISADVANTAGES PEOPLE MAY FACEIN SOCIAL ROLES. THE RESULTS LEAD TO STRONGER OUTCOMES FOR THEINSTITUTE'S PATIENTS WITH THE ABILITY TO FUNCTION AS INDEPENDENTLY ASPOSSIBLE AND ACTIVELY PARTICIPATE IN THEIR OWN COMMUNITY.$4,485,902 WAS AWARDED IN 2021 TO SUPPORT THE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES, INPATIENT REHABILITATIVE SERVICES, COMMUNITY BASED SERVICES, INDEPENDENT LIVING SKILLS (ILS) PROGRAM AND SPORTS AND RECREATION PROGRAMS OF COURAGE KENNY REHABILITATION INSTITUTE, AN UNINCORPORATED DIVISION OF ALLINA HEALTH SYSTEM. COURAGE KENNY REHABILITATION INSTITUTE (CKRI) CKRI REHABILITATIVE PROGRAMS WERE CREATED TO ASSIST PEOPLE ACHIEVE THEIR HIGHEST LEVEL OF INDEPENDENCE, HEALTH AND WELLNESS THROUGH THEIR SERVICES, INNOVATIVE PROGRAMS, GROUND-BREAKING RESEARCH, AND BARRIER-SHATTERING ADVOCACY. THEY OFFER PHYSICAL, OCCUPATIONAL AND SPEECH REHABILITATION THERAPY TO ACHIEVE OUTCOMES TO FUNCTION AS INDEPENDENTLY AS POSSIBLE FOR PEOPLE TO BE ABLE TO LIVE, WORK AND PLAY TO THEIR FULL POTENTIAL. PROFESSIONAL EDUCATION COURAGE KENNY REHABILITATION INSTITUTE ENSURES THAT PATIENTS RECEIVE THE HIGHEST QUALITY CARE BY ADHERING TO THE PRINCIPLES OF PATIENT CARE SET FORTH BY THE INSTITUTE OF MEDICINE: SAFE, EFFECTIVE, PATIENT-CENTERED, TIMELY, EFFICIENT AND EQUITABLE. THE FOUNDATION SUPPORTS THIS QUEST BY INVESTING IN PROFESSIONAL EDUCATION OF ITS CLINICIANS TO ACHIEVE THE HIGHEST LEVEL OF CLINICAL COMPETENCE.COURAGE KENNY RESEARCH CENTER (CKRC) $71,646 SUPPORTED THE COURAGE KENNY RESEARCH CENTER IN 2021. THE RESEARCH CENTER, ESTABLISHED IN 2007, SERVES AS A LABORATORY FOR CLINICAL RESEARCH, INNOVATION AND EDUCATION WITH THE GOAL OF OPTIMIZING THE CARE AND QUALITY OF LIFE FOR ALL PERSONS, BUT IN PARTICULAR THOSE LIVING WITH DISABILITIES. THE RESEARCH CENTER HAS ACHIEVED SIGNIFICANT MILESTONES INCLUDING THE DEVELOPMENT OF PATENTABLE TECHNOLOGIES, AS WELL AS ESTABLISHING EDUCATIONAL AND ENTREPRENEURIAL COLLABORATIVE RELATIONSHIPS. 87896 87896 DONATION OF ASSISTIVE DEVICES TO BE USED WITH THE PATIENTS OF COURAGE KENNY REHABILITATION INSTITUTE. 84477 84477 GRANTS TO OTHERS IN THE AMOUNT OF $84,477 WAS PAID TO SEVEN 501(C)(3) ORGANIZATIONS. 4729921 1 1 0 0 0 1 0 0 0 1 0 1 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 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 0 0 0 0 X 21 19 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN WI X TAX SERVICES MAIL ROUTE 10890 6122620660 2925 CHICAGO AVENUE MINNEAPOLIS MN 554071321 SCOTT LEIGHTY DIRECTOR 2.00 40.00 X 0 617194 172988 STEPHEN BARITEAU DIRECTOR/PRESIDENT 32.00 8.00 X X 0 311898 26853 LINDA ORTNER DIRECTOR/PRESIDENT 32.00 8.00 X X 0 179203 22235 MODENA HENDERSON DIRECTOR 2.00 40.00 X 0 185607 3253 BETH BECKER DIRECTOR 2.00 0.00 X 0 0 0 STEVE COLEMAN DIRECTOR 2.00 0.00 X 0 0 0 ROSS D'EMANUELE DIRECTOR 2.00 0.00 X 0 0 0 J MARIE FIEGER DIRECTOR 2.00 0.00 X 0 0 0 JAMES GRESHAM DIRECTOR 2.00 0.00 X 0 0 0 TIM GUNDERSON DIRECTOR 2.00 0.00 X 0 0 0 VALERIE HERRING DIRECTOR 2.00 0.00 X 0 0 0 GARY JOHANSEN DIRECTOR 2.00 0.00 X 0 0 0 ANDY KRANE DIR/CHAIR 2.00 0.00 X 0 0 0 MARK KRANZ DIRECTOR 2.00 0.00 X 0 0 0 RICHARD LAY DIRECTOR 2.00 0.00 X 0 0 0 NICKI LERITZ DIRECTOR 2.00 0.00 X 0 0 0 ROBERT MALCOMSON DIRECTOR/TREASURER 2.00 0.00 X 0 0 0 MIKE MCPARLAN DIRECTOR/TREASURER 2.00 0.00 X 0 0 0 JOSH ORTIZ DIRECTOR 2.00 0.00 X 0 0 0 SUSAN PIVA DIRECTOR 2.00 0.00 X 0 0 0 JOSH REBHOLZ DIRECTOR 2.00 0.00 X 0 0 0 SUSAN RHODE DIRECTOR 2.00 0.00 X 0 0 0 DAN SEEMAN DIRECTOR 2.00 0.00 X 0 0 0 ERIC SHERMAN DIRECTOR 2.00 0.00 X 0 0 0 BOB SPENCER DIRECTOR/VICE CHAIR/SEC. 2.00 0.00 X 0 0 0 PETER STITELER DIRECTOR 2.00 0.00 X 0 0 0 DARCY SWENSON DIRECTOR 2.00 0.00 X 0 0 0 JOSIE TAYLOR DIRECTOR 2.00 0.00 X 0 0 0 JIM VEDDER DIRECTOR 2.00 0.00 X 0 0 0 BECKY WALKER DIRECTOR 2.00 0.00 X 0 0 0 RICHARD MAGNUSON CFO 2.00 40.00 X 0 1027520 367050 0 2321422 592379 0 0 1 0 0 21484 809086 610574 6562732 260531 8003876 531314 531314 10931728 10308559 623169 623169 623169 156 809086 55206 -55050 -55050 93010 148376 -55366 -55366 9047943 -55366 0 1099433 4729921 4729921 117523 65813 51710 FOUNDATION STAFF SVCS 889320 498019 391301 PURCH SVCS - AFFILIATES 536230 536230 44331 24825 19506 6317325 4729921 1124887 462517 176187 270332 123200 36369307 39748798 1465604 2750233 38134298 42769363 1076741 1073766 1076741 1073766 X 7726399 8328954 29331158 33366643 37057557 41695597 38134298 42769363 X 2730618 1899635 7787 X X 0 1 X 1 0 X 6807643 6850646 5948398 5697361 8003876 33307924 6807643 6850646 5948398 5697361 8003876 33307924 1332206 31975718 640674 797613 914167 450396 1154483 3957333 -116305 -129875 -45182 670386 -55049 323975 37589232 0.85070 0.82810 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 131324 106477 278472 1 1 21046623 44581 2073381 657684 22506901 19234790 64764 2382002 634933 21046623 16916529 30120 2626771 338630 19234790 17767748 54124 -448928 456415 16916529 15911054 23249 2255674 422229 17767748 0.44380 0.55620 0 0 0 EQUITY SECURITIES 12515802 F FIXED INCOME SECURITIES 17461642 F FUNDS OF HEDGE FUNDS 2533452 F COMMODITIES & OTHER 5272666 F MONEY MARKET 1965236 F 39748798 DUE FROM ALLINA HEALTH SYSTEM 2001671 ASSETS HELD IN CHARITABLE REMAINDER TRUST 676066 CASH SURRENDER VALUE 72496 2750233 REMAINDER TRUST BENEFICIARIES PAYABLE 1073766 1073766 X 11103741 1899635 156163 2055798 9047943 0 9047943 6465701 148376 148376 6317325 0 6317325 PART V, LINE 4: CHARITY AND INDIGENT CARE. EDUCATION AND RESEARCH. BUILDINGS AND EQUIPMENT. PATIENT CARE. PART X, LINE 2: THE FOLLOWING IS A COPY OF NOTE 1 TO THE AUDITED FINANCIAL STATEMENTS: "SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - INCOME TAX" "THE FOUNDATION HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE INDICATING THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(S) OF THE INTERNAL REVENUE CODE (IRC) AS AN ORGANIZATION DESCRIBED IN SECTIONS 501(C)(3) AND 509(A)(3) AND THAT CHARITABLE CONTRIBUTIONS BY DONORS ARE DEDUCTIBLE UNDER SECTION 107 OF THE IRC. 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 BUSINES INCOME, EXCISE OR OTHER TAXES." PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 7,788. CARDS FOR COURAGE 148,375. PART XII, LINE 2D - OTHER ADJUSTMENTS: CARDS FOR COURAGE 148,376. TOAST TO COURAGE 501744 501638 106 610 120 700 25481 CELEBRATION OF COURAGE 177689 177689 406 22544 1 129809 129759 50 368 280 4698 809242 809086 156 610 894 980 52723 55207 -55051 1 ALLINA HEALTH SYSTEM DBA COURAGE KENNY REHABILITATION SERVICES 800 E 28TH STREET MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 4485902 0 SUPPORT COURAGE KENNY PROGRAM COSTS AND PROVIDE PATIENT CARE EQUIPMENT ALLINA HEALTH SYSTEM DBA COURAGE KENNY REHABILITATION SERVICES 800 E 28TH STREET MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 71646 0 SUPPORT RESEARCH CENTER OPERATIONS AND VARIOUS RESEARCH STUDIES ALLINA HEALTH SYSTEM DBA COURAGE KENNY REHABILITATION SERVICES 800 E 28TH STREET MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 0 87896 FMV POWER WHEELCHAIRS, ASSISTIVE DEVICES DONATION OF ASSISTIVE DEVICES TO BE USED WITH PATIENTS OF COURAGE KENNY REHABILITATION INSTITUTE. TRUE FRIENDS 10509 108TH ST NW ANNANDALE MN 55302 411543013 501(C)(3) 53577 0 GENERAL SUPPORT FOR CAMP PROVIDING EXPERIENCES ENHANCING INDEPENDENCE AND SELF-ESTEEM FOR THOSE WITH DISABILITIES;THERAPEUTIC HORSEBACK RIDING PROGRAM;ENDOWMENT FUND IMMANUEL LUTHERAN CHURCH 16515 LUTHER WAY EDEN PRAIRIE MN 55346 410968965 501(C)(3) 22000 0 SUPPORT BUILDING UP CAPITAL CAMPAIGN AND GENERAL CHURCH OPERATIONS CHILDRENS HEALTH CARE FOUNDATION 2525 CHICAGO AVENUE SOUTH MINNEAPOLIS MN 55404 411814223 501(C)(3) 7500 0 GENERAL SUPPORT FOR CHILDREN'S OF MINNESOTA FOUNDATION PART I, LINE 2: COURAGE KENNY 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 PROCESS WHICH INCLUDES A WRITTEN APPLICATION WHICH REQUIRES 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. 1 1 0 0 0 1 1 0 1 1 RICHARD MAGNUSON CFO 0 744289 0 171787 0 111444 0 348531 0 18519 0 1394570 0 245697 SCOTT LEIGHTY DIRECTOR 0 537647 0 19396 0 60151 0 138125 0 34863 0 790182 0 19396 STEPHEN BARITEAU DIRECTOR/PRESIDENT 0 138799 0 0 0 173099 0 8668 0 18185 0 338751 0 31401 LINDA ORTNER DIRECTOR/PRESIDENT 0 177400 0 0 0 1803 0 9105 0 13130 0 201438 0 0 MODENA HENDERSON DIRECTOR 0 92664 0 50000 0 42943 0 623 0 2630 0 188860 0 0 PART I, LINE 3 SEE NARRATIVE ON SCHEDULE O - FOR FORM 990, PART VI, SECTION A, LINE 6. PART I, LINES 4A-B LINE 4(A): STEPHEN BARITEAU - $82,550 LINE 4(B): STEPHEN BARITEAU - $89,379; RICHARD MAGNUSON - $85,662. 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 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 DISCLOSURES: 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 PRIORITY 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. THE MUTUAL FUND PLANS TERMINATED EFFECTIVE DECEMBER 31, 2018. ALL MUTUAL FUND ACCOUNTS SHALL BE DISTRIBUTED IN A LUMP SUM NO LATER THAN JANUARY 2021, OR IF ELECTED BY THE PARTICIPANT IN DECEMBER 2018, IN THREE ANNUAL INSTALLMENTS WITH THE FIRST HAVING BEEN MADE FEBRUARY 2019 (33.33 PERCENT OF ACCOUNT BALANCE), THE SECOND MADE FEBRUARY 2020 (50 PERCENT OF REMAINING BALANCE), AND THE THIRD MADE JANUARY 2021 (REMAINING BALANCE). ALLINA EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN (ERBRP) 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 PRIORITY 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 WHOSE 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 11 172635 FAIR MARKET VALUE X EQUIPMENT 45 87896 FAIR MARKET VALUE 0 1 1 PART I, LINE 32B: COURAGE KENNY FOUNDATION MAY FROM TIME TO TIME AND IN THE ORDINARY COURSE OF ITS CHARITABLE ACTIVITIES ACCEPT NONCASH CONTRIBUTIONS OF PUBLICLY TRADED SECURITIES. COURAGE KENNY FOUNDATION USES THIRD PARTIES SUCH AS SECURITIES BROKERAGE FIRMS TO LIQUIDATE THE PUBLICLY TRADED SECURITIES TO CASH ON THE OPEN SECURITIES MARKET. THE SALE OF PUBLICLY TRADED SECURITIES ARE GENERALLY SUBJECT TO MARKET RATE BROKERAGE COMMISSIONS AND FEES OF THE THIRD PARTY SECURITIES BROKER. COURAGE KENNY FOUNDATION CASH AND INVESTMENTS ARE POOLED WITH ITS SOLE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM, AND ITS RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP - SUSAN RHODE AND JAMES VEDDER SHARE AN EMPLOYER. JAMES VEDDER ALSO SERVES AS AN OFFICER AND DIRECTOR OF SHARED EMPLOYER. FORM 990, PART VI, SECTION A, LINE 4 ON APRIL 1, 2022, ALLINA HEALTH SYSTEM AND THE COURAGE KENNY FOUNDATION BOARDS FILED ARTICLES OF MERGER WITH THE MINNESOTA SECRETARY OF STATE REFLECTING THE MERGERS OF COURAGE KENNY FOUNDATION, A MINNESOTA NONPROFIT CORPORATION, INTO ALLINA HEALTH FOUNDATION, A MINNESOTA NONPROFIT CORPORATION. THE FOUNDATION WAS EXEMPT FROM FEDERAL INCOME TAX AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND THE RESULTING UNIFIED FOUNDATION CONTINUES TO BE EXEMPT UNDER SECTION 501(C)(3). THE MERGER WAS EFFECTIVE APRIL 1, 2022. PURSUANT TO MINNESOTA STATUTES, SECTION 317A.811, SUBD. 6, AND THE SECRETARY OF STATE ISSUED CERTIFICATES OF MERGER EFFECTIVE APRIL 1, 2022. FORM 990, PART VI, SECTION A, LINE 6 PARENT ORGANIZATION ALLINA HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER ORGANIZATION OF COURAGE KENNY FOUNDATION. SEE SCHEDULE R FOR FURTHER DETAILS. ALLINA HEALTH SYSTEM PROVIDES COURAGE KENNY FOUNDATION WITH ADMINISTRATIVE AND STAFF SERVICES AT NO COST. THE VALUE OF THE SERVICES PROVIDED BY ALLINA HEALTH SYSTEM TO COURAGE KENNY FOUNDATION DURING 2021 WERE ESTIMATED AT $405,574 AND HAVE BEEN RECORDED AS CONTRIBUTION REVENUE FROM A RELATED ORGANIZATION IN THE STATEMENT OF REVENUE AND AS ADMINISTRATIVE AND FUNDRAISING EXPENSES IN THE STATEMENT OF FUNCTIONAL EXPENSES. COURAGE KENNY 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 COURAGE KENNY FOUNDATION. THE RESERVED POWERS ARE FULLY DESCRIBED IN COURAGE KENNY FOUNDATION'S GOVERNING DOCUMENTS AND INCLUDE SUCH POWERS AS ELECTION AND APPROVAL OF DIRECTORS, 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 A, LINE 7B SEE FORM 990, PART VI, SECTION A, LINE 7A AND THE DESCRIPTION ABOVE RELATED TO IT IN SCHEDULE O. FORM 990, PART VI, SECTION B, LINE 11B COURAGE KENNY FOUNDATION'S FORM 990 WAS PREPARED BY THE TAX SERVICES FUNCTION OF ALLINA HEALTH SYSTEM, COURAGE KENNY FOUNDATION'S SOLE CORPORATE MEMBER. THE FORM 990 FILING WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA'S 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, AS THE SUCCESSOR IN MERGER. 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 MINNESOTA CHARITABLE ORGANIZATION 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 COURAGE KENNY 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 OF 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 COURAGE KENNY 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, FORM 990, PART VI, SECTION B, LINES 15A AND 15B ARE NOT APPLICABLE TO COURAGE KENNY FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 COURAGE KENNY 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: COURAGE KENNY 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 7,787. FORM 990, PART XII, LINE 2C: AS A RESULT OF THE MERGER WITH AND INTO ALLINA HEALTH FOUNDATION, THE ALLINA HEALTH FOUNDATION ASSUMED AUTHORITY, RESPONSIBILITY AND OVERSIGHT. 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