2021-11-15T06:41:19-06:00 2020-12-31 861065772 DELOITTE TAX LLP 50 SOUTH SIXTH STREET SUITE 2800 MINNEAPOLIS MN 55402 990 2020-01-01 450344371 F-M AMBULANCE SERVICE INC F-MA 7012342000 PO BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 BILL MARLETTE CFO & TREASURER 6053331000 2021-11-15 1 BILL MARLETTE XXX-XX-XXXX CHRIS MESKIMEN P01314196 6123974000 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z BILL GASSEN 2301 EAST 60TH ST SIOUX FALLS SD 57104 17460621 0 X WWW.FMAMBULANCE.COM X 1978 ND "DEDICATED TO THE WORK OF HEALTH AND HEALING" 12 5 0 0 0 0 83234 930278 17858616 16516908 -10173 2977 -13976 9352 17917701 17459515 960 0 0 0 9957144 10149657 0 0 0 3678638 3634876 13636742 13784533 4280959 3674982 6987738 6442712 123451 108308 6864287 6334404 X THE MISSION OF F-M AMBULANCE, "DEDICATED TO SHARING GOD'S LOVE THROUGH THE WORK OF HEALTH, HEALING AND COMFORT AND THE VISION "IMPROVING THE HUMAN CONDITION THROUGH EXCEPTIONAL CARE, INNOVATION AND DISCOVERY", IS THE CONSTANT FORCE THAT DRIVES OUR PLANS, DECISIONS AND ACTIONS. 0 0 11619388 16516908 AS PART OF THE SANFORD HEALTH INTEGRATED DELIVERY SYSTEM, F-M AMBULANCE SERVICE, INC. (FMA) PROVIDES EMERGENCY MEDICAL CARE AND SPECIALTY CARE TRANSPORTATION SERVICES TO FARGO, NORTH DAKOTA/MOORHEAD, MINNESOTA METRO AREA AND SURROUNDING COMMUNITIES. FMA IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF AMBULANCE SERVICES (CAAS) AND IS THE LARGEST ADVANCED LIFE SUPPORT GROUND AMBULANCE PROVIDER IN NORTH DAKOTA AND OUTSTATE MINNESOTA. FMA RESPONDS TO MORE THAN 33,000 CALLS FOR SERVICE ANNUALLY WHICH RESULTED IN TRANSPORTING MORE THAN 27,000 PEOPLE AND OVER 6,000 CALLS THAT DID NOT RESULT IN A PATIENT TRANSPORT. FMA SERVES AS A RESOURCE TO RESCUE SQUADS, FIRE DEPARTMENTS, LAW ENFORCEMENT AGENCIES AND BASIC LIFE SUPPORT AMBULANCE PROVIDERS THROUGHOUT THE STATE. FMA PROVIDES TACTICAL PARAMEDICS FOR THE REGIONAL S.W.A.T. TEAM AND PROVIDES FIREFIGHTER REHAB SERVICES PRO-BONO. FMA WORKS CLOSELY WITH LOCAL VOLUNTEER SERVICES TO COORDINATE THE DELIVERY OF EMERGENCY MEDICAL CARE TO COMMUNITIES IN ITS SERVICE AREA AND IS A LEADER IN HOMELAND DEFENSE PREPAREDNESS BY SERVING AS A REGIONAL TRAINING SITE, RESOURCES PARTNER AND FIRST RESPONDER.THROUGH ITS READY WHEELS OPERATIONS (A SPECIALTY CARE TRANSPORTATION SERVICE), FMA PROVIDES LOCAL AND LONG DISTANCE TRANSPORTATION FOR INDIVIDUALS CONFINED TO WHEELCHAIRS. THIS SPECIALTY CARE TRANSPORTATION SERVICE IS AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO PROVIDE DOOR-TO-DOOR SERVICE. THESE SERVICES ALLOW INDIVIDUALS IN THE COMMUNITY TO ACCESS TRANSPORTATION SERVICES THAT ACCOMMODATE UNIQUE INDIVIDUAL NEEDS DUE TO HEALTH CONDITIONS.EDUCATION AND OTHER SERVICES:FMA PROMOTES COMMUNITY HEALTH AND INJURY PREVENTION WITH MORE THAN 10,000 MEMBERS OF THE PUBLIC EACH YEAR PARTICIPATING IN FIRST AID, AUTOMATED EXTERNAL DEFIBRILLATOR, CPR, BABYSITTER TRAINING AND OTHER COMMUNITY WELLNESS COURSES. FMA IS ALSO THE HOME TO THE REGION'S LARGEST INITIAL EMS CERTIFICATION CENTER. EMERGENCY MEDICAL RESPONDER CLASSES ARE TAUGHT TO AREA FIRE DEPARTMENTS, LAW ENFORCEMENT AGENCIES AND LOCAL OR INDUSTRIAL RESCUE SQUADS. EMT CLASSES ARE HELD MULTIPLE TIMES A YEAR AND SUPPLY STAFFING FOR FULL-TIME AND VOLUNTEER AGENCIES ACROSS OUR AREA. IN CONJUNCTION WITH THE NORTH DAKOTA STATE COLLEGE OF SCIENCE, OUR PARAMEDIC PROGRAM OFFERS AN ASSOCIATE DEGREE LEVEL COURSE ACCREDITED BY THE COMMISSION ON ACCREDITATION OF ALLIED HEALTH EDUCATION PROGRAMS (ONE OF 3 IN ND). FMA ALSO OFFERS RECERTIFICATION COURSES IN-PERSON AND VIRTUALLY THAT ARE ACCREDITED THROUGH THE COMMISSION ON ACCREDITATION FOR PRE-HOSPITAL CONTINUING EDUCATION (ONLY ONE IN ND). SEVERAL OF OUR EDUCATORS ARE ACTIVE REGIONALLY AND NATIONALLY ON EMS EDUCATION TOPICS. 11619388 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 X 12 5 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X BILL MARLETTE CFO & TREASURER 6053331000 2301 EAST 60TH STREET SIOUX FALLS SD 57104 X BRENT TEIKEN CHARIPERSON 0.50 6.61 X X 0 68500 0 DON JACOBS VICE CHAIRPERSON 0.50 6.61 X X 0 44000 0 NEIL GULSVIG TREASURER 0.50 6.61 X X 0 38500 0 ANDY NORTH SECRETARY 0.50 6.61 X X 0 310804 0 MARK PAULSON MD PAST CHAIR/PHYSICIAN REGIONAL CHAIR 0.50 59.50 X X 0 294486 39555 BARB EVERIST TRUSTEE 0.50 6.61 X 0 36500 0 DAVID BEITO TRUSTEE 0.50 6.61 X 0 41500 0 JAMES CAIN TRUSTEE 0.50 6.61 X 0 35500 0 MARIA BELL MD TRUSTEE/RESEARCH ADMINISTRATOR 0.50 59.50 X 0 1013142 42910 MARK LUNDEEN MD TRUSTEE/ORTHOPEDICS SERVICE CHAIR 0.50 59.50 X 0 692452 36756 MARK LUNDEEN MD SEE SCH J, PART III, LINES 4A-4B 0.50 59.50 X 0 1000000 0 PATRICK DURICK TRUSTEE 0.50 6.61 X 0 36000 0 KELBY KRABBENHOLT PRESIDENT & CEO (THRU 11/20) 0.50 59.50 X X 0 5077342 68527 KELBY KRABBENHOLT SEE SCH J, PART III, LINES 4A-4B 0.50 59.50 X X 0 44353819 0 BILL GASSEN III CAO/PRESIDENT & CEO (START 11/20) 0.50 59.50 X X 0 1517211 103667 BILL GASSEN III SEE SCH J, PART III, LINES 4A-4B 0.50 59.50 X X 0 1100000 0 JOANN KUNKEL CHIEF FINANCIAL OFFICER (THRU 9/20) 0.50 59.50 X 0 1312771 34314 JOANN KUNKEL SEE SCH J, PART III, LINES 4A-4B 0.50 59.50 X 0 6847438 0 BILL MARLETTE CFO (START 10/20) & TREASURER 0.50 59.50 X 0 1749053 31556 BILL MARLETTE SEE SCH J, PART III, LINES 4A-4B 0.50 59.50 X 0 5903232 0 BRYAN NERMOE PRESIDENT, FARGO 5.00 55.00 X 0 944836 121890 NATE WHITE FORMER PRESIDENT, FARGO (THRU4/20) 0.00 60.00 X 0 733362 14565 NATE WHITE SEE SCH J, PART III, LINES 4A-4B 0.00 60.00 X 0 3281646 0 0 76432094 493740 0 1 1 0 0 1086 929192 930278 EMERGENCY MEDICAL SERV 621910 15832400 15832400 EDUCATION 611430 516880 516880 SPECIAL TRANSPORTATION 621910 167628 167628 16516908 2 2 2975 0 2975 2975 2975 10458 1106 9352 9352 17459515 16516908 0 12329 8300709 7213604 1087105 406604 354805 51799 808809 647877 160932 633535 553623 79912 3859 3859 665723 611606 54117 28661 27817 844 131222 84940 46282 275912 7210 268702 241508 154706 86802 267960 254621 13339 173778 170489 3289 815605 741152 74453 173646 173646 MEDICAL SUPPLIES 764008 729400 34608 MINNESOTACARE TAX 53267 53267 39727 14271 25456 13784533 11619388 2165145 0 247 -10060 1343949 1123374 2407 7531 119763 17413 10293260 6790517 3485784 3502743 1393082 1393082 642506 408629 6987738 6442712 106273 108308 17178 0 123451 108308 X 6864287 6334404 6864287 6334404 6987738 6442712 X 3674982 -4204865 X 0 1 X 1 0 410810 410810 2372230 1347061 1025169 7375167 5329595 2045572 135053 113861 21192 3502743 OTHER ASSETS-CIP 408629 408629 X PART X, LINE 2: CERTAIN CONTROLLED ORGANIZATIONS ARE SUBJECT TO INCOME TAXES. DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE DIFFERENCES BETWEEN THE FINANCIAL AND INCOME TAX REPORTING BASIS OF ASSETS AND LIABILITIES BASED ON ENACTED TAX RATES AND LAWS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THE DEFERRED INCOME TAX PROVISION OR BENEFIT GENERALLY REFLECTS THE NET CHANGE IN DEFERRED INCOME TAX ASSETS AND LIABILITIES DURING THE YEAR. THE CURRENT INCOME TAX PROVISION REFLECTS THE TAX CONSEQUENCES OF REVENUES AND EXPENSES CURRENTLY TAXABLE OR DEDUCTIBLE ON VARIOUS INCOME TAX RETURNS FOR THE YEAR REPORTED. F-M AMBULANCE SERVICE, INC DID NOT HAVE AN INCOME TAX LIABILITY AT DECEMBER 31, 2020; SOME RELATED ORGANIZATIONS HAVE ESTABLISHED RESERVES. 1 1 0 0 0 0 0 0 0 ANDY NORTH SECRETARY 0 310804 0 0 0 0 0 0 0 0 0 310804 0 0 MARK PAULSON MD PAST CHAIR/PHYSICIAN REGIONAL CHAIR 0 281084 0 15000 0 -1598 0 12271 0 27284 0 334041 0 0 MARIA BELL MD TRUSTEE/RESEARCH ADMINISTRATOR 0 906084 0 54000 0 53058 0 14250 0 28660 0 1056052 0 0 MARK LUNDEEN MD TRUSTEE/ORTHOPEDICS SERVICE CHAIR 0 691892 0 0 0 560 0 14250 0 22506 0 729208 0 0 MARK LUNDEEN MD SEE SCH J, PART III, LINES 4A-4B 0 0 0 0 0 1000000 0 0 0 0 0 1000000 0 0 KELBY KRABBENHOLT PRESIDENT & CEO (THRU 11/20) 0 3028187 0 1971204 0 77951 0 45148 0 23379 0 5145869 0 0 KELBY KRABBENHOLT SEE SCH J, PART III, LINES 4A-4B 0 0 0 0 0 44353819 0 0 0 0 0 44353819 0 8183861 BILL GASSEN III CAO/PRESIDENT & CEO (START 11/20) 0 1098215 0 244003 0 174993 0 101820 0 1847 0 1620878 0 0 BILL GASSEN III SEE SCH J, PART III, LINES 4A-4B 0 0 0 1100000 0 0 0 0 0 0 0 1100000 0 0 JOANN KUNKEL CHIEF FINANCIAL OFFICER (THRU 9/20) 0 852418 0 309501 0 150852 0 11827 0 22487 0 1347085 0 0 JOANN KUNKEL SEE SCH J, PART III, LINES 4A-4B 0 0 0 0 0 6847438 0 0 0 0 0 6847438 0 221828 BILL MARLETTE CFO (START 10/20) & TREASURER 0 1210291 0 317501 0 221261 0 29289 0 2267 0 1780609 0 0 BILL MARLETTE SEE SCH J, PART III, LINES 4A-4B 0 0 0 0 0 5903232 0 0 0 0 0 5903232 0 1662810 BRYAN NERMOE PRESIDENT, FARGO 0 791837 0 22000 0 130999 0 98220 0 23670 0 1066726 0 0 NATE WHITE FORMER PRESIDENT, FARGO (THRU4/20) 0 365485 0 300000 0 67877 0 14250 0 315 0 747927 0 0 NATE WHITE SEE SCH J, PART III, LINES 4A-4B 0 0 0 0 0 3281646 0 0 0 0 0 3281646 0 237188 PART I, LINE 1A CERTAIN ITEMS LISTED ON LINE 1A ARE PROVIDED BY RELATED ORGANIZATIONS. PART I, LINE 3: THE EXECUTIVE COMPENSATION COMMITTEE OF THE SANFORD BOARD OF TRUSTEES DIRECTLY ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO, AND TO REPORT THE FINDINGS TO THEM FOR DELIBERATION AND ACTION. THE DELIBERATIONS AND ACTIONS ARE RECORDED IN THE MINUTES OF THE SANFORD BOARD OF TRUSTEES. THE MOST RECENT STUDY WAS COMPLETED IN 2020. PART I, LINES 4A-B LINA 4A - SEVERANCE OR CHANGE OF CONTROL UPON HIRE OR PROMOTION, SELECT OFFICERS AND KEY EMPLOYEES SIGN AN EXECUTIVE SEVERANCE AGREEMENT (THE "AGREEMENT"). THE AGREEMENT PROVIDES THAT THE EXECUTIVE WILL RECEIVE A MULTIPLE OF HIS OR HER SALARY (BASED ON YEARS OF SERVICE OR POSITION) AS A PAYMENT IN THE EVENT OF A DEFINED SEPARATION EVENT, WHICH CAN INCLUDE AN INVOLUNTARY SEPARATION OR AN EMPLOYEE VOLUNTARILY LEAVING FOR A DEFINED CONTRACTUAL REASON. FINAL SEPARATION PAYMENTS MIGHT VARY FROM THE AMOUNT PROVIDED IN THE AGREEMENT AS A RESULT OF NEGOTIATIONS SURROUNDING EARLY RETIREMENTS AND POST-SEPARATION OBLIGATIONS AND INCENTIVES (THE "SEPARATION" PAYMENT). LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS - DEFINED BENEFIT SERP ANNUITY PLAN IN 1983, A DEFINED BENEFIT SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("DB SERP ANNUITY PLAN") WAS ESTABLISHED. THE DB SERP ANNUITY PLAN PROVIDED LIFETIME ANNUITY PAYMENTS TO PLAN PARTICIPANTS BASED ON THEIR HISTORICAL SALARY AND YEARS OF SERVICE. THE ANNUITY BENEFIT WAS DESIGNED TO PROVIDE A SIMILAR BENEFIT AS PROVIDED BY THE QUALIFIED DEFINED BENEFIT PENSION PLAN. AS OF 2020, KELBY KRABBENHOFT AND BILL MARLETTE, WITH 24 AND 31 YEARS OF SERVICE RESPECTIVELY, WERE THE ONLY TWO REMAINING PARTICIPANTS. IN NOVEMBER 2020, THE SANFORD BOARD OF TRUSTEES MADE THE DECISION TO ACCELERATE TERMINATION OF THE DB SERP ANNUITY PLAN TO LIMIT FUTURE FINANCIAL LIABILITY AND BECAUSE SANFORD DOES NOT INTEND TO USE AN AVERAGE PAY/ANNUITY SUPPLEMENTAL STRUCTURE ON A GO FORWARD BASIS. KELBY KRABBENHOFT'S AND BILL MARLETTE'S BENEFIT HAD BEEN PREVIOUSLY ACCRUED FOR AND DISCLOSED AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON HISTORICAL 990 FORMS. AS A RESULT OF THE PLAN TERMINATION, THE TOTAL BENEFIT WAS VESTED AND REPORTABLE AS TAXABLE INCOME ON THE PLAN PARTICIPANTS' W-2S IN 2020. LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS - DEFINED BENEFIT SERP LUMP SUM PLANS AS ALSO REQUIRED BY PLAN TERMINATION RULES, SANFORD TERMINATED ALL OTHER DEFINED BENEFIT SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS. KELBY KRABBENHOFT PARTICIPATED IN A DB SERP LUMP SUM PLAN TIED TO RETENTION AND HIS SUCCESSION PLAN. MARK LUNDEEN PARTICIPATED IN A SEPARATE DB SERP LUMP SUM PLAN TIED TO RETENTION. LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS - DEFINED CONTRIBUTION SERP PLAN SANFORD SPONSORS A DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("DC SERP PLAN") FOR SELECT OFFICERS OR KEY EMPLOYEES. THE DC SERP PLAN PROVIDES THAT SANFORD WILL MAKE DISCRETIONARY CONTRIBUTIONS INTO PARTICIPANT ACCOUNTS. CERTAIN OF THE BELOW OFFICERS OR KEY EMPLOYEES WERE PAID AS A RESULT OF A VESTING EVENT WHICH INCLUDE REACHING A PRE-ESTABLISHED RETIREMENT AGE OR A DEFINED SEPARATION EVENT. LINES 4A AND 4B - PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS AND/OR SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: MARK LUNDEEN, 40 YEARS OF SERVICE: DB SERP PLAN $1,000,000 KELBY KRABBENHOFT, 24 YEARS OF SERVICE: SEPARATION $15,000,000 DB SERP ANNUITY AND LUMP SUM PLANS $29,353,819 TOTAL $44,353,819 BILL GASSEN III, 9 YEARS OF SERVICE: RETENTION PLAN AGREEMENT $1,100,000 JOANN KUNKEL, 28 YEARS OF SERVICE: SEPARATION $6,498,707 DC SERP PLAN $348,731 TOTAL $6,847,438 BILL MARLETTE, 31 YEARS OF SERVICE: DB SERP ANNUITY PLAN $5,903,232 NATE WHITE, 16 YEARS OF SERVICE: SEPARATION $2,970,256 DC SERP PLAN $311,390 TOTAL $3,281,646 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE EMPLOYEES OF SANFORD OR ITS RELATED ORGANIZATIONS. MANY OF THESE EMPLOYEES ALSO SERVE ON OTHER RELATED SANFORD BOARDS, OR HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER THAT SPAN THE ORGANIZATION AS A WHOLE: MARIA BELL, MARK LUNDEEN, MARK PAULSON, BRYAN NERMOE, KELBY KRABBENHOFT, JOANN KUNKEL, NATE WHITE, BILL MARLETTE, AND BILL GASSEN. FORM 990, PART VI, SECTION A, LINE 6 SANFORD NORTH IS THE SOLE STOCKHOLDER OF F-M AMBULANCE. FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS ARE APPOINTED BY THE PRESIDENT AND CEO OF SANFORD NORTH. FORM 990, PART VI, SECTION A, LINE 7B SANFORD NORTH MUST APPROVE THE FOLLOWING ACTIONS: * MODIFYING THE PURPOSE OF THE CORPORATION * UNBUDGETED CAPITAL EXPENSES IN EXCESS OF 1/2 OF 1% OF APPROVED OPERATING BUDGETS *ADOPTION OF CAPITAL AND OPERATING BUDGETS *ACQUISITION, SALE, LEASE, DISPOSITION, OR MORTGAGING OF REAL PROPERTY *GUARANTEE OF DEBTS OR OBLIGATIONS OF ANY OTHER PERSON, FIRM, CORPORATION, PARTNERSHIP, ASSOCIATION, OR OTHER ENTITY WHICH IF HELD IN DEFAULT WOULD OBLIGATE THE CORPORATION TO AN AGGREGATE AMOUNT IN EXCESS OF $100,000 *MERGER OR CONSOLIDATION OF THE CORPORATION *INCURRING A LOAN OR OTHER OBLIGATION IN AN AGREEMENT IN EXCESS OF $500,000 FOR MORE THAN 60 DAYS *MAKING OF A GIFT, GRANT OR OTHER DONATION IN AN AMOUNT IN EXCESS OF $5,000 TO AN ORGANIZATION NOT RELATED TO THE CORPORATION OR MEMBER *MEMBER HAS THE AUTHORITY TO DIRECT THE CORPORATION REGARDLESS OF THE VOTE BY THE CORPORATION'S BOARD OF DIRECTORS TO TRANSFER ASSETS AND/OR FUNDS TO THE HEALTH SYSTEM TO SATISFY OBLIGATIONS OF THE HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. AN EXTERNAL ACCOUNTING FIRM REVIEWS THE RETURN. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR THE BOARD OF TRUSTEES MEETING PRIOR TO THE RETURN FILING DATE. BEFORE THE RETURN IS FILED, A COMPLETE COPY IS PROVIDED TO THE CURRENT BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS IS MANAGED BY THE CHIEF COMPLIANCE OFFICER (CCO). THE CCO IS RESPONSIBLE FOR ASSURING THAT ALL COMPLETED FORMS ARE RETURNED IN A TIMELY AND COMPLETE MANNER. CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT TO SYSTEM TRUSTEES, MEMBERS OF THE GOVERNING BOARDS FOR SUBSIDIARY ENTITIES, OFFICERS, AND KEY EMPLOYEES FOR ALL ENTITIES SUBJECT TO THE IRS FORM 990 FILINGS. THE DISCLOSURES ARE SUMMARIZED FOR REVIEW BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, PURSUANT TO POLICY. THIS REVIEW ALLOWS: 1) THE BOARD TO ACQUIRE AN AWARENESS OF FINANCIAL RELATIONSHIPS OF BOARD MEMBERS AND KEY MANAGEMENT EMPLOYEES AND CAN INVOKE THE RECUSAL PROCESS ON A CASE-BY-CASE BASIS IF POTENTIAL CONFLICTS ARE IMPLICATED IN BOARD DECISIONS AND DELIBERATIONS, AND, 2) GIVES THE BOARD THE OPPORTUNITY TO SEEK ADDITIONAL INFORMATION AND CLARIFICATION ABOUT DISCLOSURES TO DETERMINE POTENTIAL CONFLICTS OF INTEREST AND HOW TO MANAGE THEM. FORM 990, PART VI, SECTION B, LINE 15 A RELATED PARTY, SANFORD HEALTH, DOES HAVE A PROCESS FOR DETERMINING COMPENSATION OF THE PERSONS LISTED ON PART VII SECTION A, INCLUDING A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, REVIEW OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION FOR SUCH COMPENSATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE SANFORD BOARD OF TRUSTEES DIRECTLY ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO, AND TO REPORT THE FINDINGS TO THEM FOR DELIBERATION AND ACTION. THE DELIBERATIONS AND ACTIONS ARE RECORDED IN THE MINUTES OF THE SANFORD BOARD OF TRUSTEES. THE MOST RECENT STUDY WAS COMPLETED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH THE ORGANIZATION DOES NOT MAINTAIN A WEBSITE WHERE THE PUBLIC CAN ACCESS THESE DOCUMENTS, IT WOULD RESPOND INDIVIDUALLY TO ANY REQUESTS OR INQUIRIES FROM THE PUBLIC FOR THESE DOCUMENTS. FORM 990, PART VII THE SANFORD BOARD OF TRUSTEES HAS ULTIMATE GOVERNANCE RESPONSIBILITIES FOR EACH MAJOR OPERATION ENTITY WITHIN SANFORD. IN ADDITION, A BOARD OF DIRECTORS IS ESTABLISHED FOR EACH MAJOR OPERATING ENTITY. THIS BOARD HAS SPECIFIC RESPONSIBILITIES DELEGATED FROM THE BOARD OF TRUSTEES. GENERALLY THESE RESPONSIBILITIES ARE RELATED TO THE OVERSIGHT OF THE DAY TO DAY OPERATIONS OF THAT ENTITY. FORM 990, PART XI, LINE 9: TRANSFER TO RELATED TAX-EXEMPT ORG FOR PAYROLL AND OPERATING EXPENSES -4,204,865. SANFORD P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271218956 SUPPORTING ORGANIZATION ND 501(C)(3) 12-II 0 SANFORD HEALTH FOUNDATION P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 363297853 FOUNDATION SD 501(C)(3) 12-II SANFORD HEALTH 1 SANFORD HEALTH FOUNDATION NORTH P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450398104 FOUNDATION ND 501(C)(3) 7 SANFORD NORTH 1 SANFORD HEALTH FOUNDATION HILLSBORO P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 363542187 FOUNDATION ND 501(C)(3) 7 SANFORD HEALTH NETWORK NORTH 1 SANFORD HEALTH FOUNDATION WEST P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450397196 FOUNDATION ND 501(C)(3) 7 SANFORD BISMARCK 1 SANFORD HEART OF AMERICA HEALTH PLAN P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450346132 INSURANCE ND 501(C)(4) SANFORD HEALTH PLAN 1 SANFORD HEALTH FOUNDATION THIEF RIVER FALLS P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 411761135 FOUNDATION MN 501(C)(3) 7 SANFORD HEALTH NETWORK NORTH 1 SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 411389317 FOUNDATION MN 501(C)(3) 7 SANFORD HEALTH OF NORTHERN MINNESOTA 1 SANFORD-GOOD SAMARITAN COMMUNITY HEALTH SERVICES LLC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 371834045 LONG-TERM CARE, SENIOR LIVING, AND POST-ACUTE FACILITIES ND 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 ADAMS COUNTY GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 461495572 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 ALLIANCE GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 204714573 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 ARLINGTON GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 371805492 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 BOISE GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 363370371 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 BROOKINGS GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460439509 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 COLLISTER DRIVE HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 300872973 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 EL PASO GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 272876627 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 GOOD SAMARITAN HOLDINGS LLC P O BOX 5039 RTE 5218 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