2021-11-15T13:32:06-06:00 2020-12-31 135565207 KPMG LLP 4200 WELLS FARGO CTR 90S7TH STREET MINNEAPOLIS MN 55402 990 2020-01-01 391726539 AMERY REGIONAL MEDICAL CENTER FOUNDATION INC AMER 7152688000 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 DEBRA A RUDQUIST PRESIDENT 7152688000 2021-11-12 1 DEBRA RUDQUIST 999009999 HOLLLY K MOEN P01800653 6123055000 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DEBRA A RUDQUIST 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 1383018 0 X WWW.AMERYMEDICALCENTER.ORG X 1991 WI TO PROMOTE THE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED BY AMERY REGIONAL MEDICAL CENTER. 8 6 0 6 0 0 405320 1376534 0 0 3350 2284 17698 2255 426368 1381073 270186 53945 0 0 0 0 0 0 0 114458 70146 384644 124091 41724 1256982 706221 1832774 131511 1082 574710 1831692 X THE AMERY REGIONAL MEDICAL CENTER FOUNDATION (FOUNDATION) EXISTS TO PROMOTE THE HEALTH AND WELLNESS OF THE PEOPLE IN THE COMMUNITIES SERVED BY AMERY REGIONAL MEDICAL CENTER (ARMC) BY PARTICIPATING IN VARIOUS FUNDRAISING ACTIVITIES. 0 0 124091 53945 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS 124091 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 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 1 1 0 0 0 0 0 0 X 8 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X DOUG JOHNSON CFO 7152688000 265 GRIFFIN STREET EAST AMERY WI 54001 X JOYCE SCHAEFER DIRECTOR & CHAIR 0.75 0.00 X X 0 0 0 BRIAN BYRNES DIRECTOR & SECRETARY & TRE 0.50 0.00 X X 0 0 0 JON BUSS DIRECTOR 0.50 0.00 X 0 0 0 BRUCE F DENNISON MD DIRECTOR 0.50 39.50 X 0 362473 56422 SHARI OVERBY DIRECTOR 0.50 0.00 X 0 0 0 J MARTIN NOONAN DIRECTOR & VICE CHAIR 0.50 0.00 X X 0 0 0 JAMES QUENAN MD DIRECTOR 0.50 0.00 X 0 0 0 ANN R SEAGREN MD DIRECTOR 0.50 49.75 X 0 242337 80053 DIANE C MCNEIL EXECUTIVE DIRECTOR 45.00 0.00 X 0 98931 11904 DOUGLAS E JOHNSON CFO 0.50 54.50 X 0 415631 40274 DEBRA A RUDQUIST PRESIDENT 0.50 49.50 X 0 338363 55642 JASON J LUHRS FORMER CFO 0.00 50.00 X 0 270087 51349 0 1727822 295644 0 1 1 0 0 37372 295 1338867 1376534 2284 2284 4200 37372 1945 2255 2255 1381073 0 0 4539 X 53945 53945 32047 32047 10205 10205 2544 2544 215 215 MISCELLANEOUS OTHER EXP 25135 25135 124091 124091 0 0 683052 1828395 23169 4379 706221 1832774 131511 1082 131511 1082 X 574710 1831692 574710 1831692 706221 1832774 1256982 0 X 0 1 X 1 0 X 181416 253561 324463 405320 126534 1291294 181416 253561 324463 405320 126534 1291294 339910 951384 412 920 2997 3350 2284 9963 1301257 166805 0.73110 0.70280 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: AMERY REGIONAL MEDICAL CENTER FOUNDATION, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT 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, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2020 OR 2019 FOR UNRECOGNIZED TAX BENEFITS. GOLF TOURNAMENT 27950 23750 4200 1945 SHOPPING EVENT 13622 13622 0 41572 37372 4200 1945 1945 2255 1 ST CROIX VALLEY FOUNDATION 516 SECOND ST SUITE 214 HUDSON WI 54016 411817315 501(C)(3) 14050 PROGRAM SUPPORT CHILDREN'S HEALTH ALLIANCE OF WISCONSIN 1716 FONDEM AVE MADISON WI 53704 391792143 501(C)(3) 20000 PROGRAM SUPPORT 2 PART I, LINE 2: AMERY REGIONAL MEDICAL CENTER FOUNDATION (FOUNDATION) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH THE FOUNDATION'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO THE FOUNDATION'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. 0 0 0 0 0 0 1 0 0 DOUGLAS E JOHNSON CFO 0 325510 0 58036 0 32085 0 5700 0 34574 0 455905 0 0 BRUCE F DENNISON MD DIRECTOR 0 256658 0 0 0 105815 0 21375 0 35047 0 418895 0 0 DEBRA A RUDQUIST PRESIDENT 0 297382 0 36834 0 4147 0 22992 0 32650 0 394005 0 0 ANN R SEAGREN MD DIRECTOR 0 178395 0 0 0 63942 0 46497 0 33556 0 322390 0 0 JASON J LUHRS FORMER CFO 0 223370 0 33735 0 12982 0 17706 0 33643 0 321436 0 0 PART I, LINE 3 THE FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ALL OFFICERS AND KEY EMPLOYEES ARE PAID BY GROUP HEALTH PLAN, INC. (GHI), REGIONS HOSPITAL, OR AMERY REGIONAL MEDICAL CENTER, RELATED ORGANIZATIONS. ANY COMPENSATION DISCLOSED IS DETERMINED SOLELY BY THE RELATED ORGANIZATIONS. PART I, LINE 6 THE FOUNDATION HAS NO EMPLOYEES. THE FOUNDATION'S PRESIDENT IS EMPLOYED BY REGIONS HOSPITAL, INC. (RH), WHICH HAS AN INCENTIVE PROGRAM WHICH INCENTS AND REWARDS THE RH'S EMPLOYEES WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC YEAR. HOW THE PROGRAM WORKS: THE HOSPITAL INCENTIVE PROGRAM REWARDS ARE BASED ON POSITION IN THE ORGANIZATION AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, PATIENT EDUCATION, SIX AIMS, MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE, ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. FORM 990, PART III, LINE 4A - "EXEMPT PURPOSE AND ACHIEVEMENTS" CORPORATE STRUCTURE, PURPOSE, GOVERNANCE AMERY REGIONAL MEDICAL CENTER FOUNDATION, INC. (THE FOUNDATION), IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE HEALTHPARTNERS ORGANIZATION ("HEALTHPARTNERS"). FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED HEALTH CARE ORGANIZATION, PROVIDING HEALTH CARE SERVICES AND HEALTH PLAN FINANCING AND ADMINISTRATION, AND IS THE LARGEST CONSUMER-GOVERNED NONPROFIT HEALTH CARE ORGANIZATION IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTH CARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS, INC. (HPI) IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4) AND IS THE PARENT ENTITY OF HEALTHPARTNERS ORGANIZATIONS REFERRED TO COLLECTIVELY AS "HEALTHPARTNERS". HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS. HEALTHPARTNERS PROVIDES A FULL RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLANS SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,800 EMPLOYED PHYSICIANS AND DENTISTS, EIGHT OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 129 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN SERVING MORE THAN 1.27 MILLION PATIENTS. HEALTHPARTNERS HEALTH PLANS CONTRACT WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS TO SERVE PLAN MEMBERS. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. HEALTHPARTNERS COLLABORATES WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2020 ARE TOTAL COST OF CARE MEASUREMENTS (A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN HEALTHPARTNERS, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NONPROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, LAKEVIEW HEALTH, RAMSEY INTEGRATED HEALTH SERVICES, AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN AND GROUP HEALTH PLAN, INC. (GHI) ARE CORPORATE MEMBERS OF AMERY REGIONAL MEDICAL CENTER, INC. (ARMC). ARMC IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3). IN TURN, ARMC IS THE SOLE CORPORATE MEMBER OF THE FOUNDATION. AMERY REGIONAL MEDICAL CENTER IS DOING BUSINESS AS AMERY HOSPITAL & CLINIC (AHC). THE FOUNDATION EXISTS TO PROMOTE THE HEALTH AND WELLNESS OF THE PEOPLE IN THE COMMUNITIES SERVED BY AHC BY PARTICIPATING IN VARIOUS FUNDRAISING ACTIVITIES. BENEFIT TO THE COMMUNITY FUNDRAISERS IN THE FALL OF 2020, THE FOUNDATION CONDUCTED ITS ANNUAL EMPLOYEE GIVING CAMPAIGN, RAISING $16,874 FROM AHC AND HEALTHPARTNERS EMPLOYEES. THE FUNDS WERE DIRECTED TO COMMUNITY HEALTH INITIATIVES, PATIENT CARE NEEDS, EMPLOYEE TO EMPLOYEE ASSISTANCE AND GREATEST NEED. IN SEPTEMBER OF 2020, THE FOUNDATION HELD ITS 32ND ANNUAL GOLF CLASSIC FOR COVID19 RESPONSE & RELIEF. THE EVENT GROSSED $26,950 AND NETTED $25,165 FOR THE AHC EMERGENCY DEPARTMENT ENTRANCE. IN NOVEMBER, A VIRTUAL SILENT AUCTION WAS HELD TO SUPPORT THE AHC EMERGENCY DEPARTMENT AS WELL. THIS EVENT CALLED "HUNTER'S WIDOWS SHOPPING EXTRAVAGANZA" RAISED $23,794. DONATIONS RECEIVED IN ADDITION TO THESE FUND RAISING EVENTS, THE FOUNDATION RECEIVED $20,816 IN GENERAL DONATIONS AND MEMORIALS. GRANTS RECEIVED THE FOUNDATION ALSO RECEIVED $1,271,333 IN OUTSIDE GRANTS: $1.25 MILLION DOLLARS WAS RECEIVED FROM THE FRED C AND KATHERINE B. ANDERSEN FOUNDATION TO REMODEL THE BEHAVIORAL HEALTH UNIT ON THE WEST CAMPUS. $11,500 WAS RECEIVED FROM OTTO BREMER TRUST FOR COVID19 RESPONSE & RELIEF $5,000 WAS RECEIVED FROM THE ST. CROIX VALLEY FOUNDATION FOR COVID19 RESPONSE & RELIEF. $2,500 WAS RECEIVED FROM MIDWEST RADIOLOGY FOR THE EMERGENCY DEPARTMENT ENTRY. $2,333 WAS RECEIVED FROM THE UNITED WAY ST. CROIX VALLEY FOR TRANSPORTATION OF ED PATIENTS IN NEED. HOSPITAL SUPPORTED PROGRAMS/COMMUNITY CONTRIBUTIONS THE FOUNDATION STRATEGICALLY PARTNERS WITH AHC TO ENHANCE PATIENT CARE, TO PROVIDE EVIDENCE BASED TRAINING FOR STAFF, AND TO PROMOTE HEALTH AND WELLBEING WITHIN THE COMMUNITY. HOSPITAL SUPPORTED PROGRAMS: BEHAVIORAL HEALTH DEPARTMENT REMODEL: THE FOUNDATION RAISED $1,257,485. THE PROJECT IS CURRENTLY IN PROGRESS AND COMPLETION IS EXPECTED BY THE END OF 2021. COMMUNITY HEALTH: THE FOUNDATION PROUDLY SUPPORTED THE POWERUP FOR KIDS HEALTHY LIFESTYLES PROGRAM AND MAKE IT OK MENTAL HEALTH AWARENESS PROGRAM WITH $96,474. BOTH OF THESE PROGRAMS RAISE AWARENESS AND TEACH HOW TO MAKE HEALTH CHOICES AS WELL AS ADVOCATE FOR ONE'S PERSONAL HEALTH AND WELLBEING. COVID19 RESPONSE & RELIEF: THE FOUNDATION PROVIDED $3,517 IN SUPPORT TO THE HOSPITAL FOR VARIOUS NEEDS THAT QUICKLY AROSE FROM THE PANDEMIC. THIS INCLUDED THE CREATION OF A CALMING ROOM FOR STAFF TO REST DURING THEIR STRESSFUL SHIFTS, THE PURCHASE OF TELEMETRY EQUIPMENT FOR CARDIAC MONITORING CAPABILITIES IN ANY PATIENT ROOM, AND THE PURCHASE OF AN OPTIFLOW HIGH FLOW OXYGEN UNIT FOR RESPIRATORY PATIENTS. ED TRANSPORTATION: THE FOUNDATION SUPPORTED THE EMERGENCY DEPARTMENT WITH $2,351 OF TRANSPORTATION FUNDS FOR BEHAVIORAL HEALTH PATIENTS IN THE ED. EMPLOYEE EMERGENCY: THE FOUNDATION PROVIDED $3,675 OF SUPPORT TO EMPLOYEES IN A TEMPORARY FINANCIAL CRISIS DUE TO A PERSONAL EMERGENCY SITUATION. THESE FUNDS WERE GIVEN IN A VERY SELECTIVE PROCESS AND WERE REQUESTED BY EMPLOYEES THEMSELVES. COMMUNITY SUPPORTED PROGRAMS MENTAL HEALTH WALK/RUN: THE FOUNDATION SPONSORED THE POLK COUNTY SUICIDE AWARENESS WALK. HOWEVER, IT WAS CANCELLED DUE TO COVID IN 2020. THIS EVENT RAISES AWARENESS ABOUT MENTAL HEALTH AND HONORS THE LIVES OF THOSE LOST TO SUICIDE IN POLK COUNTY. COMMUNITY GARDEN: THE FOUNDATION SUPPORTED THE COMMUNITY GARDEN PROGRAM WITH $6,706 FOR OPERATIONAL EXPENSES OF THE COMMUNITY WIDE GARDEN PLOTS. THE VOLUNTEERS OF THE COMMUNITY GARDEN PARTNER WITH THE CITY OF AMERY, THE HUNGRY TURTLE FOOD INSTITUTE, THE AMERY HOUSING AUTHORITY, AND THE AMERY FOOD SHELF. COOKING CLASSES WITH FRESH LOCALLY GROWN FOODS ARE OFFERED LOCALLY. OVER 200 POUNDS OF FRESH VEGETABLES ARE GROWN AND DISTRIBUTED TO THE FOOD SHELF. THE AMERY HOUSING AUTHORITY BUILDS RAISED BEDS AT NO COST TO GROW FOOD, AND AHC DONATES GARDEN BED SPACE TO SUPPORT THIS WELLNESS EFFORT. HIGH SCHOOL SENIOR SCHOLARSHIPS: THE FOUNDATION PARTNERS WITH AHC TO FUND SCHOLARSHIPS TO ELIGIBLE HIGH SCHOOL SENIORS IN 7 DIFFERENT SCHOOL DISTRICTS WHO PLAN TO PURSUE EDUCATION IN THE HEALTHCARE FIELD AFTER GRADUATION. THE FOUNDATION PROVIDED $4,000 IN FUNDS FOR THIS PROGRAM. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE FOUNDATION IS ARMC. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO BYLAWS, THE FOUNDATIONS BOARD OF DIRECTORS IS COMPRISED OF AT LEAST 5 BUT NO MORE THAN 9 PERSONS. AT LEAST 2 DIRECTORS MUST BE APPOINTED BY ARMC, THE FOUNDATION'S SOLE MEMBER, AND THE REMAINING DIRECTOR POSITIONS ARE FILLED BY PERSONS NOMINATED BY THE BOARD AND APPROVED BY THE ARMC. THE PRESIDENT OF ARMC SERVES AS AN EX-OFFICIO, NON-VOTING DIRECTOR. FORM 990, PART VI, SECTION A, LINE 7B THE FOUNDATION'S CORPORATE MEMBER, ARMC, MUST APPROVE THE FOLLOWING ACTIONS OF THE FOUNDATION'S BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY: A. ADOPTION OF THE FOUNDATION'S ANNUAL BUDGET B. ADOPTION OF THE FOUNDATION'S STRATEGIC PLANS C. AMENDMENT OF THE FOUNDATION'S BYLAWS D. AMENDMENT OF THE FOUNDATION'S ARTICLES OF INCORPORATION E. ANY CHANGE, AMENDMENT, OR ALTERATION IN THE SLATED PURPOSES FOR WHICH THE FOUNDATION IS ORGANIZED F. ANY GRANT GREATER THAN $10,000 TO AN ENTITY OTHER THAN ARMC OR ANY ENTITY AFFILIATED WITH ARMC G. ELECTION OF THE FOUNDATION'S OFFICERS FORM 990, PART VI, SECTION B, LINE 11B THE FOUNDATION'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE FOUNDATION. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE FOUNDATION, GHI'S INTERNAL LEGAL DEPARTMENT AND THE FOUNDATION'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF THE FOUNDATION. ONCE THAT REVIEW PROCESS HAS BEEN COMPLETED, IT IS THE POLICY OF THE FOUNDATION TO MAKE AVAILABLE TO THE BOARD OF DIRECTORS OF THE FOUNDATION A COPY OF THE 990 PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT A MEETING OF THE FULL BOARD OF DIRECTORS. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN MINUTES OF THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES ("COVERED PERSONS") BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, COVERED PERSONS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND ASKED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE LEGAL DEPARTMENT OF HEALTHPARTNERS REVIEWS THE QUESTIONNAIRE RESPONSES AND DEVELOPS A REPORT DETAILING ANY POTENTIALLY MATERIAL CONFLICTS FOR THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD OR APPROPRIATE COMMITTEE ENDING WITH A REMINDER TO COVERED PERSONS OF THE POLICY'S MANDATE THAT EACH PERSON IS OBLIGATED TO DISCLOSE ANY NEW POTENTIAL CONFLICTS AS THEY MAY ARISE THROUGHOUT THE YEAR. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ALL OFFICERS AND KEY EMPLOYEES ARE PAID BY GROUP HEALTH PLAN, INC. (GHI), REGIONS HOSPITAL, OR AMERY REGIONAL MEDICAL CENTER, RELATED ORGANIZATIONS. ANY COMPENSATION DISCLOSED IS PAID AND DETERMINED SOLELY BY THE RELATED ORGANIZATIONS. THEREFORE, PART VI, SECTION B, QUESTION 15 IS NOT APPLICABLE TO THE FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE FOUNDATION OR HEALTHPARTNERS. 990, PART VII, SECT A, LN 1A, COL (B): AVERAGE HRS - RELATED ORGANIZATION ALL DIRECTORS AND OFFICERS OF THE FOUNDATION ARE EMPLOYED AND COMPENSATED BY GROUP HEALTH PLAN, INC., REGIONS HOSPITAL OR AMERY REGIONAL MEDICAL CENTER. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 32,047. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,047. HEALTHPARTNERS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411693838 HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4) N/A 0 HPI-RAMSEY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411793333 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 GROUP HEALTH PLAN INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410797853 STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC 0 RH WISCONSIN INC 8171 33RD AVE S PO BOX 1309 MPLS MN 554401309 202287016 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HPI - RAMSEY 0 HEALTHPARTNERS INSTITUTE 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411670163 HEALTHCARE EDUCATION AND RESEARCH MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 CAPITOL VIEW TRANSITIONAL CARE CENTER 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 412011453 TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410956618 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411888902 PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY 0 RHSC INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411891928 HEALTHCARE STAFFING AND INTENSE REHAB SERVICES MN 501(C)(3) 509(A)(3) TYPE II HEALTHPARTNERS INC 0 PHYSICIANS NECK & BACK CLINICS 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 270684883 SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC 0 HUDSON HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390804125 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN INC 0 HUDSON HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391279567 PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH WI 501(C)(3) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC 0 LAKEVIEW HEALTH FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411386635 PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) LAKEVIEW HEALTH 0 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410811697 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) LAKEVIEW HEALTH 0 STILLWATER MEDICAL GROUP 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 830379473 CLINIC STAFF AND FACILITIES MN 501(C)(3) 509(A)(3) TYPE I LAKEVIEW HEALTH 0 LAKEVIEW HEALTH 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 300221189 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE II HPI - 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