NAEVE HEALTH CARE FOUNDATION: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: NAEVE HEALTH CARE FOUNDATION (EIN 41-1989509)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-11-16
IRS object ID: 202013219349301621
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-16T07:20:40-06:00	ReturnTs
Tax Period End	2019-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	121 WEST BRIDGE STREET	AddressLine1Txt
City	OWATONNA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55060	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	411989509	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NAEVE HEALTH CARE FOUNDATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	NAEV	BusinessNameControlTxt
Phone	5074341595	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	404 WEST FOUNTAIN ST	AddressLine1Txt
City	ALBERT LEA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56007	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DANIEL KOLKER	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	5074341595	PhoneNum
Signature	2020-11-03	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	BRAD SVENBY	PreparerPersonNm
PTIN	P00449887	PTIN
Phone	5074467100	PhoneNum
Preparation	2020-11-03	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	67.137.57.251	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-11-03	IPDt
IP Tm	08:31:04	IPTm
IP Timezone	CS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	6BCE17CF531EE5E889DFF9A1732B3E9930A5A1A9	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DANIEL KOLKER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	404 WEST FOUNTAIN ST	AddressLine1Txt
City	ALBERT LEA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56007	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,998,179	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.NAEVEFOUNDATION.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2000	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	RAISING PHILANTHROPIC DOLLARS FOR HIGH QUALITY COST EFFECTIVE HEALTHCARE AT MCHS IN ALBERT LEA.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	15	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	16	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,174	PYContributionsGrantsAmt
CY Contributions Grants	$42,827	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$210,321	PYInvestmentIncomeAmt
CY Investment Income	$197,866	CYInvestmentIncomeAmt
PY Other Revenue	$3	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$216,498	PYTotalRevenueAmt
CY Total Revenue	$240,693	CYTotalRevenueAmt
PY Grants And Similar Paid	$214,695	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$42,512	PYOtherExpensesAmt
CY Other Expenses	$38,097	CYOtherExpensesAmt
PY Total Expenses	$257,207	PYTotalExpensesAmt
CY Total Expenses	$38,097	CYTotalExpensesAmt
PY Revenues Less Expenses	-$40,709	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$202,596	CYRevenuesLessExpensesAmt
Total Assets BOY	$4,502,612	TotalAssetsBOYAmt
Total Assets EOY	$5,345,864	TotalAssetsEOYAmt
Total Liabilities BOY	$0	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$4,502,612	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$5,345,864	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Desc	NAEVE HEALTH CARE FOUNDATION'S GIFT WAS DIRECTED TOWARDS PROJECTS WITHIN MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA.	Desc
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	0	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	15	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARK CHRISTOPHERSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5074341069	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 FIRST DRIVE NW	AddressLine1Txt
City	AUSTIN	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55912	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
DAN KOLKER
DIRECTOR	12.00	Yes (X)	Yes (X)	$0	$0	$0
ALEX JOHNSTON
VICE PRESIDENT	12.00	Yes (X)	Yes (X)	$0	$0	$0
SUE LOCH
PRESIDENT	12.00	Yes (X)	Yes (X)	$0	$0	$0
RICH MURRAY
TREASURER	12.00	Yes (X)	Yes (X)	$0	$0	$0
DIANE CLARK
SECRETARY	12.00	Yes (X)	Yes (X)	$0	$0	$0
STEPHEN BROWNLOW
DIRECTOR	8.00	Yes (X)		$0	$0	$0
DIANE DAMEROW
DIRECTOR	8.00	Yes (X)		$0	$0	$0
KAREN CONN
DIRECTOR	8.00	Yes (X)		$0	$0	$0
DR TED MYERS
DIRECTOR	8.00	Yes (X)		$0	$0	$0
MOLLEE TSCHOLL
DIRECTOR	8.00	Yes (X)		$0	$0	$0
KARI ULRICH
DIRECTOR	8.00	Yes (X)		$0	$0	$0
CORRINE TIMS
DIRECTOR	8.00	Yes (X)		$0	$0	$0
DR MARK CIOTA
EX-OFFICIO OFFICER	0.00		Yes (X)	$0	$0	$0
VIRGINIA LARSON
DIRECTOR	0.00	Yes (X)		$0	$0	$0
DIANNE WICHMAN
DIRECTOR	0.00	Yes (X)		$0	$0	$0
GARY SCHINDLER
DIRECTOR	0.00	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$42,827	AllOtherContributionsAmt
Total Contributions	$42,827	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$119,978	TotalRevenueColumnAmt
Exclusion	$119,978	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,835,374	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,757,486	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$77,888	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$77,888	TotalRevenueColumnAmt
Exclusion	$77,888	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$240,693	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$197,866	ExclusionAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,400	TotalAmt
Management And General	$1,400	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$36,404	TotalAmt
Management And General	$36,404	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$25	TotalAmt
Management And General	$25	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Desc	MISCELLANEOUS EXPENSE	Desc
Total	$268	TotalAmt
Management And General	$268	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$38,097	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$38,097	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$14,607	BOYAmt
EOY	$15,778	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$4,477,722	BOYAmt
EOY	$5,319,969	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$10,283	BOYAmt
EOY	$10,117	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,502,612	BOYAmt
EOY	$5,345,864	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,058,700	BOYAmt
EOY	$4,821,968	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$443,912	BOYAmt
EOY	$523,896	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,502,612	BOYAmt
EOY	$5,345,864	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,502,612	BOYAmt
EOY	$5,345,864	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$202,596	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$640,656	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	Yes (X)	SupportingOrganization509a3Ind
Supporting Org Type3 Non Func	Yes (X)	SupportingOrgType3NonFuncInd
IRS Written Determination	Yes (X)	IRSWrittenDeterminationInd
Supported Organizations	1	SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CLINIC HEALTH SYSTEMS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
EIN	411404075	EIN
Organization Type	3	OrganizationTypeCd
Governing Document Listed	Yes (1)	GoverningDocumentListedInd
Support	$0	SupportAmt
Other Support	$0	OtherSupportAmt

Field	Value	IRS element (for citing)
Supported Organizations Total	1	SupportedOrganizationsTotalCnt
Support Sum	$0	SupportSumAmt
Other Support Sum	$0	OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

Field	Value	IRS element (for citing)
Listed By Name Governing Doc	Yes (1)	ListedByNameGoverningDocInd
Suprt Org No IRS Determination	0	SuprtOrgNoIRSDeterminationInd
Supported Org Section C456	0	SupportedOrgSectionC456Ind
Supported Org Not Organized US	0	SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org	0	OrganizationChangeSuprtOrgInd
Support Non Supported Org	0	SupportNonSupportedOrgInd
Payment Substantial Contribtr	0	PaymentSubstantialContribtrInd
Loan Disqualified Person	0	LoanDisqualifiedPersonInd
Controlled Disqualified Prsn	0	ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int	0	DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int	0	DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules	Yes (1)	ExcessBusinessHoldingsRulesInd
Excess Business Holdings	0	ExcessBusinessHoldingsInd
Contribution Controller	0	ContributionControllerInd
Contribution Family	0	ContributionFamilyInd
Contribution35 Controlled	0	Contribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

Field	Value	IRS element (for citing)
Timely Provided Documents	Yes (1)	TimelyProvidedDocumentsInd
Officers Close Relationship	Yes (1)	OfficersCloseRelationshipInd
Supported Org Voice Investment	Yes (1)	SupportedOrgVoiceInvestmentInd

Adjusted Net Income AdjustedNetIncomeGrp

Net ST Capital Gain Adj Net Incm NetSTCapitalGainAdjNetIncmGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt
Current Year	$0	CurrentYearAmt

Recoveries PY Distributions RecoveriesPYDistributionsGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt
Current Year	$0	CurrentYearAmt

Other Gross Income OtherGrossIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$109,950	PriorYearAmt
Current Year	$119,978	CurrentYearAmt

Adjusted Gross Income AdjustedGrossIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$109,950	PriorYearAmt
Current Year	$119,978	CurrentYearAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt
Current Year	$0	CurrentYearAmt

Production Income ProductionIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$37,410	PriorYearAmt
Current Year	$36,404	CurrentYearAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt
Current Year	$0	CurrentYearAmt

Total Adjusted Net Income TotalAdjustedNetIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$72,540	PriorYearAmt
Current Year	$83,574	CurrentYearAmt

Minimum Asset Amount MinimumAssetAmountGrp

Average Monthly FMV Of Sec AverageMonthlyFMVOfSecGrp

Field	Value	IRS element (for citing)
Prior Year	$4,830,852	PriorYearAmt
Current Year	$4,920,353	CurrentYearAmt

Average Monthly Cash Balances AverageMonthlyCashBalancesGrp

Field	Value	IRS element (for citing)
Prior Year	$33,979	PriorYearAmt
Current Year	$32,908	CurrentYearAmt

FMV Other Non Exempt Use Asset FMVOtherNonExemptUseAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt
Current Year	$0	CurrentYearAmt

Total FMV Of Non Exempt Use Asset TotalFMVOfNonExemptUseAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$4,864,831	PriorYearAmt
Current Year	$4,953,261	CurrentYearAmt

Field	Value	IRS element (for citing)
Discount Claimed	$0	DiscountClaimedAmt

Acquisition Indebtedness AcquisitionIndebtednessGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt
Current Year	$0	CurrentYearAmt

Adjusted FMV Less Indebtedness AdjustedFMVLessIndebtednessGrp

Field	Value	IRS element (for citing)
Prior Year	$4,864,831	PriorYearAmt
Current Year	$4,953,261	CurrentYearAmt

Cash Deemed Charitable CashDeemedCharitableGrp

Field	Value	IRS element (for citing)
Prior Year	$72,972	PriorYearAmt
Current Year	$74,299	CurrentYearAmt

Net Vl Non Exempt Use Assets NetVlNonExemptUseAssetsGrp

Field	Value	IRS element (for citing)
Prior Year	$4,791,859	PriorYearAmt
Current Year	$4,878,962	CurrentYearAmt

Pct Of Net Vl Non Exempt Use Ast PctOfNetVlNonExemptUseAstGrp

Field	Value	IRS element (for citing)
Prior Year	$167,715	PriorYearAmt
Current Year	$170,764	CurrentYearAmt

Recoveries PY Distri Min Asset RecoveriesPYDistriMinAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt
Current Year	$0	CurrentYearAmt

Total Minimum Asset TotalMinimumAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$167,715	PriorYearAmt
Current Year	$170,764	CurrentYearAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
CY Adj Net Income Distributable	$72,540	CYAdjNetIncomeDistributableAmt
CY Pct85 Adjusted Net Income	$61,659	CYPct85AdjustedNetIncomeAmt
CY Total Min Ast Distributable	$167,715	CYTotalMinAstDistributableAmt
CY Greater Adjusted Minimum	$167,715	CYGreaterAdjustedMinimumAmt
CY Income Tax Imposed PY	$0	CYIncomeTaxImposedPYAmt
CY Distributable As Adjusted	$167,715	CYDistributableAsAdjustedAmt

Distributions DistributionsGrp

Field	Value	IRS element (for citing)
CY Paid Accomplish Exempt Prps	$0	CYPaidAccomplishExemptPrpsAmt
CY Pd In Excess Income Activity	$0	CYPdInExcessIncomeActivityAmt
CY Administrative Expense Paid	$0	CYAdministrativeExpensePaidAmt
Exempt Use Assets Acquis Paid	$0	ExemptUseAssetsAcquisPaidAmt
Qualified Set Aside	$0	QualifiedSetAsideAmt
CY Other Distributions	$0	CYOtherDistributionsAmt
CY Total Annual Distributions	$0	CYTotalAnnualDistributionsAmt
CY Distri Attentive Suprt Org	$0	CYDistriAttentiveSuprtOrgAmt
CY Distributable As Adjusted	$167,715	CYDistributableAsAdjustedAmt
CY Distribution Yr	0.000000000000	CYDistributionYrRt

Distribution Allocations DistributionAllocationsGrp

Field	Value	IRS element (for citing)
CY Distributable As Adjusted	$167,715	CYDistributableAsAdjustedAmt
Underdistributions	$0	UnderdistributionsAmt
Excess Distribution Cyov Yr5	$0	ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4	$0	ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3	$0	ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2	$0	ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1	$42,767	ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov	$42,767	TotalExcessDistributionCyovAmt
Cyov Applied Underdistri PY	$0	CyovAppliedUnderdistriPYAmt
Cyov Applied Underdistr CPY	$42,767	CyovAppliedUnderdistrCPYAmt
Carryover PY Not Applied	$0	CarryoverPYNotAppliedAmt
Excess Distribution Cyov	$0	ExcessDistributionCyovAmt
CY Total Annual Distributions	$0	CYTotalAnnualDistributionsAmt
CY Distrib App Underdistri PY	$0	CYDistribAppUnderdistriPYAmt
Excess Distribution	$0	ExcessDistributionAmt
Remaining Underdistri PY	$0	RemainingUnderdistriPYAmt
Remaining Underdistri CY	$124,948	RemainingUnderdistriCYAmt
Excess Distri Cyov To Next Yr	$0	ExcessDistriCyovToNextYrAmt
Excess From Year5	$0	ExcessFromYear5Amt
Excess From Year4	$0	ExcessFromYear4Amt
Excess From Year3	$0	ExcessFromYear3Amt
Excess From Year2	$0	ExcessFromYear2Amt
Excess From Year1	$0	ExcessFromYear1Amt

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART IV, SECTION D, LINE 3 - ROLE OF SUPPORTED ORGANIZATIONS

THE CEO OF THE FOUNDATION'S SUPPORTED ORGANIZATION, MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN (THE "MEDICAL CENTER"), SERVES AS AN EX OFFICIO VOTING MEMBER OF THE BOARD OF TRUSTEES OF THE FOUNDATION. THE MEDICAL CENTER'S CEO ALSO SERVES AS AN EX OFFICIO MEMBER OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER, THUS PROVIDING REPRESENTATION OF MEDICAL CENTER LEADERSHIP ON THE BOARD OF THE FOUNDATION AT BOTH THE OFFICER AND GOVERNING BODY LEVELS OF THE MEDICAL CENTER. THE MEDICAL CENTER CEO IS COMMITTED TO ENSURING THAT THE FOUNDATION'S FACILITIES ARE MANAGED AND OPERATED IN A MATTER THAT REFLECTS THE MEDICAL CENTER'S CHARITABLE PURPOSES AND MISSION. HE IS ACTIVELY ENGAGED AS A BOARD MEMBER IN THE FOUNDATION'S GOVERNANCE AND PARTICIPATES IN DECISIONS AND DISCUSSIONS AT THE BOARD LEVEL AND WITH THE FOUNDATION'S LEADERSHIP IN ALL ASPECTS OF THE FOUNDATION'S MANAGEMENT AND USE OF ITS INCOME AND ASSETS FOR THE BENEFIT OF THE MEDICAL CENTER. IN ADDITION, THE FOUNDATION'S BYLAWS PROVIDE THAT THE FOUNDATION MUST MAINTAIN A CLOSE AND CONTINUOUS WORKING RELATIONSHIP WITH THE MEDICAL CENTER'S OFFICERS AND DIRECTORS IN ORDER TO ENSURE THAT THE MEDICAL CENTER'S LEADERSHIP HAS A SIGNIFICANT VOICE IN THE FOUNDATION'S OPERATIONS AND ITS ACQUISITION, USE, AND MANAGEMENT OF ITS INCOME AND ASSETS.

PART V, SECTION D, LINE 1 - DISTRIBUTIONS

REASONABLE CAUSE EXCEPTION: THE ORGANIZATION MISSED PAYING THE 2019 DISTRIBUTABLE AMOUNT DURING 2019 DUE TO A CLERICAL ERROR AND NOT TO WILLFUL NEGLECT. ONCE THE ORGANIZATION WAS AWARE OF THE MISSED DISTRIBUTION, THE 2019 DISTRIBUTION WAS MADE IN JANUARY 2020. THE ORGANIZATION DISTRIBUTED $215,935 IN JANUARY 2020, FOR THE 2019 DISTRIBUTION.

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$281,543	BeginningYearBalanceAmt
End Year Balance	$281,543	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$281,543	BeginningYearBalanceAmt
End Year Balance	$281,543	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$281,543	BeginningYearBalanceAmt
End Year Balance	$281,543	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$281,543	BeginningYearBalanceAmt
End Year Balance	$281,543	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$281,543	BeginningYearBalanceAmt
End Year Balance	$281,543	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings	$0	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	WELLS FARGO INVESTMENTS	Desc
Book Value	$5,319,969	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$5,319,969	TotalBookValueSecuritiesAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART XIII - SUPPLEMENTAL FINANCIAL INFORMATION	FormAndLineReferenceDesc
Explanation	PART V, LINE 4: TO SUPPORT PATIENTS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSION	TO ENSURE THE FUTURE OF LOCAL, QUALITY HEALTH CARE THROUGH THE CONTINUED DEVELOPMENT OF A PERMANENT ENDOWMENT FUND AND OTHER PHILANTHROPIC RELATIONSHIPS AND ACTIVITIES AS MAY BE DEEMED APPROPRIATE FOR THE GROWTH AND DEVELOPMENT OF MCHS IN ALBERT LEA AND SURROUNDING COMMUNITIES.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY A NATIONAL CPA OFFICE AND THEN REVIEWED BY THE BOARD MEMBERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 12C	IN ACCORDANCE WITH THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, THE FOLLOWING INDIVIDUALS ARE REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST ACKNOWLEDGEMENT: -BOARD OF TRUSTEE MEMBERS -MEMBERS OF THE MAJOR NAEVE HEALTH CARE FOUNDATION COMMITTEES ANY INDIVIDUAL FROM THE ABOVE GROUPS MAY BE ASKED TO ABSTAIN FROM VOTING OR PARTICIPATING IN THE DECISION MAKING ACTIVITIES AFFECTED BY THE CONFLICT OF INTEREST DISCLOSURE. AN INDIVIDUAL MAY BE ASKED TO LEAVE A MEETING WHERE THE DECISION MAKING ACTIVITIES WOULD BE AFFECTED BY THE CONFLICT OF INTEREST DISCLOSURE. IF AN INDIVIDUAL NEGLECTS TO DISCLOSE APPROPRIATELY, DISCIPLINARY ACTION WILL BE CONSIDERED UP TO AND INCLUDING TERMINATION OF EMPLOYMENT AND/OR POSITION ON THE FOUNDATION BOARD. THE COMPLIANCE OFFICER OF MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN ASSISTS THE BOARD IN DISTRIBUTION AND COLLECTION OF ANNUAL CONFLICT OF INTEREST DISCLOSURE FORMS.
FORM 990, PART VI, SECTION C, LINE 19	NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC.