ESSENTIA HEALTH FOUNDATION: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ESSENTIA HEALTH FOUNDATION (EIN 27-1984704)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-04-25
- IRS object ID
- 201911159349301476
- Schema version
- 2017v2.3
- 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 G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-04-25T15:57:38-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271984704 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ESSENTIA HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ESSE | BusinessNameControlTxt |
| Phone | 2187868966 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 E 2ND ST | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55805 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEREK GROVES | PersonNm |
| Person Title | CHIEF DEVELOPMENT OFFICER | PersonTitleTxt |
| Phone | 2187868966 | PhoneNum |
| Signature | 2019-04-25 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.70.11.254 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-04-25 | IPDt |
| IP Tm | 15:57:35 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 451E9B1FD6949C5516D1E526EBCF18571DBE2BB9 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEREK GROVES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 E 2ND ST | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55805 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,096,605 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ESSENTIAHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES BY FOSTERING CHARITABLE SUPPORT FOR PATIENT CARE. ESSENTIA HEALTH FOUNDATION SERVES AS AN UMBRELLA FOR LOCAL FOUNDATIONS WITHIN ESSENTIA HEALTH SYSTEM, BUILDING ON COMMON STRENGTHS AND PROVIDING ECONOMIES OF SCALE. OUR GOALS INCLUDE BUILDING UPON OUR CULTURE OF PHILANTHROPY, INCREASING FUNDRAISING, ACTING AS A RESOURCE TO LOCAL FOUNDATIONS AND THE ESSENTIA SYSTEM, AND REDUCING COSTS TO LOCAL FOUNDATIONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 305 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,663,131 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,302,378 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,093,708 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,055,537 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$102,132 | PYOtherRevenueAmt |
| CY Other Revenue | -$28,169 | CYOtherRevenueAmt |
| PY Total Revenue | $3,654,707 | PYTotalRevenueAmt |
| CY Total Revenue | $4,329,746 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,668,115 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,714,271 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $633,476 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $832,261 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $3,310 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $437,038 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $469,726 | PYOtherExpensesAmt |
| CY Other Expenses | $666,241 | CYOtherExpensesAmt |
| PY Total Expenses | $3,771,317 | PYTotalExpensesAmt |
| CY Total Expenses | $3,216,083 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$116,610 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,113,663 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,365,379 | TotalAssetsBOYAmt |
| Total Assets EOY | $30,571,940 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,813,731 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $682,914 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $27,551,648 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $29,889,026 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,860,157 | ExpenseAmt |
| Grant | $1,714,271 | GrantAmt |
| Desc | ESSENTIA HEALTH FOUNDATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, SCIENTIFIC, AND RELIGIOUS PURPOSES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF CERTAIN ESSENTIA HEALTH SUPPORTED ORGANIZATIONS, AND OF THE TAX-EXEMPT ENTITIES IDENTIFIED AS SUPPORTED ORGANIZATIONS IN THEIR RESPECTIVE ARTICLES OF INCORPORATION.ESSENTIA HEALTH FOUNDATION FACILITATES CHARITABLE FUNDRAISING FOR AND ON BEHALF OF CERTAIN ESSENTIA HEALTH SUPPORTED ORGANIZATIONS. FUNDRAISING IS CONDUCTED BY DIRECT MAIL, SPECIAL EVENTS, GRANTS FROM FOUNDATIONS AND DONATIONS FROM INDIVIDUALS. COMPANIES, FOUNDATIONS, INDIVIDUALS, PHYSICIANS, AND STAFF PARTICIPATE BY GIVING TO THE FOUNDATION. DONATIONS ARE GIVEN FOR A WIDE RANGE OF CHARITABLE NEEDS OF EACH OF THE SUPPORTED ORGANIZATIONS INCLUDING PATIENT COMPASSIONATE CARE INITIATIVES, CAPITAL IMPROVEMENTS, EQUIPMENT AND SUPPLIES, COMMUNITY EDUCATION AND OUTREACH, RESEARCH, AND EMPLOYEE ASSISTANCE. ESSENTIA HEALTH FOUNDATION PROVIDES PROGRAMMATIC SUPPORT THROUGH DISBURSEMENT OF FOUNDATION FUNDS TO PROGRAMS ADMINISTERED BY ESSENTIA HEALTH RELATED ORGANIZATIONS TO BENEFIT PATIENTS, FAMILIES AND STAFF ADVANCING OUR MISSION. IN TOTAL, $2.6 MILLION WAS GIVEN TO THE FOUNDATION IN 2018 BY 6,050 DONORS, MOST OF WHOM RESIDE IN COMMUNITIES SERVED BY ESSENTIA HEALTH. THE FOUNDATION'S LOCAL ADVISORY BOARDS DISTRIBUTED $1.7 MILLION TO ITS SUPPORTED ORGANIZATIONS AND COMMUNITY PROGRAMS WHICH IMPROVE COMMUNITY HEALTH. THE ORGANIZATIONS ESSENTIA HEALTH FOUNDATION SUPPORTS PROVIDE HEALTH CARE SERVICES TO THE GENERAL PUBLIC AS PART OF ESSENTIA HEALTH.ESSENTIA HEALTH IS AN INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, WISCONSIN, NORTH DAKOTA AND IDAHO. HEADQUARTERED IN DULUTH, MINNESOTA, ESSENTIA HEALTH COMBINES THE STRENGTHS AND TALENTS OF 14,400 EMPLOYEES, INCLUDING MORE THAN 2,000 PHYSICIANS AND ADVANCED PRACTITIONERS, WHO SERVE ITS PATIENTS AND COMMUNITIES THROUGH THE MISSION OF BEING CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. ESSENTIA HEALTH, WHICH INCLUDES MANY CATHOLIC FACILITIES, IS GUIDED BY THE VALUES OF QUALITY, HOSPITALITY, RESPECT, JOY, JUSTICE, STEWARDSHIP AND TEAMWORK. THE ORGANIZATION LIVES OUT ITS MISSION BY HAVING PATIENT-CENTERED FOCUS AT 15 HOSPITALS, OVER 70 CLINICS, SIX LONG-TERM CARE FACILITIES, THREE ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SIX AMBULANCE SERVICES, AND ONE RESEARCH INSTITUTE. ESSENTIA HEALTH PROVIDES SERVICES PREDOMINANTLY IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. MANY OF ESSENTIA HEALTH'S HOSPITALS AND CLINICS ARE LOCATED IN COMMUNITIES THAT ARE FEDERALLY RECOGNIZED AS BEING MEDICALLY UNDERSERVED. ESSENTIA HEALTH IS ACCREDITED AS AN ACCOUNTABLE CARE ORGANIZATION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH FILE SEPARATE FORM 990'S. ESSENTIA HEALTH'S HOSPITALS HAVE A TOTAL OF 1,198 LICENSED BEDS WHICH PROVIDED OVER 185,000 HOSPITAL PATIENT DAYS AND OVER 674,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2018. THE CLINICS HAD OVER 1.7 MILLION ENCOUNTERS DURING THE SAME TIME PERIOD. DURING THE FISCAL YEAR ENDED JUNE 30, 2018, ESSENTIA HEALTH PROVIDED TOTAL COMMUNITY BENEFITS OF OVER $136 MILLION WHICH INCLUDED COSTS OF PROVIDING CHARITY CARE, COSTS IN EXCESS OF MEDICAID PAYMENTS, MEDICAID SURCHARGE, MINNESOTACARE TAX, COMMUNITY SERVICES, HEALTH PROFESSION EDUCATION, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS. | Desc |
| Total Program Service Expenses | $1,860,157 | TotalProgramServiceExpensesAmt |
| 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 |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | AK | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | AR | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | KS | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MD | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MS | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NJ | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NM | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JULIE THEDENS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2187868966 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 E 2ND ST | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55805 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RICHARD BROWN | ||||||||
| BOARD CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT BENNETT | ||||||||
| BOARD DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT ERICKSON MD | ||||||||
| BOARD DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $521,417 | $56,661 | ||
| VAL KNUDSEN | ||||||||
| BOARD DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG NATHAN | ||||||||
| BOARD DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM REHDER | ||||||||
| BOARD DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE SEYFER | ||||||||
| BOARD DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM SINCLAIR | ||||||||
| BOARD DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FAYE WITT | ||||||||
| BOARD DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $25,051 | $0 | ||
| CYNDI ANDERSON | ||||||||
| BOARD CHAIR THRU 1/18 | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $1,300 | $0 | |
| DEREK GROVES | ||||||||
| CHIEF DEVELOPMENT OFFICER | 60.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES GARVEY | ||||||||
| INTERIM EXECUTIVE DIRECTOR THRU 4/18 | 1.00 | 59.00 | Yes (X) | $0 | $563,660 | $91,728 | ||
| SUSAN OMDALEN | ||||||||
| DIRECTOR OF DEVELOPMENT | 60.00 | 0.00 | $121,079 | $0 | $28,654 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $121,079 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,111,428 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $177,043 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $30,216 | FundraisingAmt |
| Related Organizations | $892,550 | RelatedOrganizationsAmt |
| All Other Contributions | $2,379,612 | AllOtherContributionsAmt |
| Noncash Contributions | $118,651 | NoncashContributionsAmt |
| Total Contributions | $3,302,378 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $590,190 | TotalRevenueColumnAmt |
| Exclusion | $590,190 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $24,062,937 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,597,590 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $465,347 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $465,347 | TotalRevenueColumnAmt |
| Exclusion | $465,347 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $130,622 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $30,216 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $158,624 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$28,002 | TotalRevenueColumnAmt |
| Exclusion | -$28,002 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $10,478 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $10,645 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$167 | TotalRevenueColumnAmt |
| Exclusion | -$167 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,329,746 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,027,368 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,402,155 | TotalAmt |
| Program Services | $1,402,155 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,116 | TotalAmt |
| Program Services | $312,116 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,208 | TotalAmt |
| Management And General | $62,898 | ManagementAndGeneralAmt |
| Fundraising | $3,310 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $611,364 | TotalAmt |
| Management And General | $297,225 | ManagementAndGeneralAmt |
| Fundraising | $314,139 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,402 | TotalAmt |
| Management And General | $12,394 | ManagementAndGeneralAmt |
| Fundraising | $11,008 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,410 | TotalAmt |
| Management And General | $43,951 | ManagementAndGeneralAmt |
| Fundraising | $41,459 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,187 | TotalAmt |
| Management And General | $26,049 | ManagementAndGeneralAmt |
| Fundraising | $23,138 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $790 | TotalAmt |
| Management And General | $790 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,273 | TotalAmt |
| Management And General | $145,273 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,785 | TotalAmt |
| Management And General | $190,593 | ManagementAndGeneralAmt |
| Fundraising | $12,192 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,963 | TotalAmt |
| Management And General | $2,615 | ManagementAndGeneralAmt |
| Fundraising | $3,348 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,050 | TotalAmt |
| Management And General | $70,792 | ManagementAndGeneralAmt |
| Fundraising | $23,258 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,983 | TotalAmt |
| Management And General | $10,983 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,954 | TotalAmt |
| Management And General | $3,583 | ManagementAndGeneralAmt |
| Fundraising | $371 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,235 | TotalAmt |
| Management And General | $35,188 | ManagementAndGeneralAmt |
| Fundraising | $4,047 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,513 | TotalAmt |
| Management And General | $7,513 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CHARITABLE GIFT ANNUITY | $145,886 | $145,886 | ||
| MISC | $5,317 | $4,823 | $494 | |
| DUES | $3,969 | $3,969 | ||
| SALES TAX | $275 | $1 | $274 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248 | TotalAmt |
| Management And General | $248 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,216,083 | TotalAmt |
| Program Services | $1,860,157 | ProgramServicesAmt |
| Management And General | $918,888 | ManagementAndGeneralAmt |
| Fundraising | $437,038 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,639 | BOYAmt |
| EOY | $1,103,117 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,183,890 | BOYAmt |
| EOY | $2,270,646 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,033,960 | BOYAmt |
| EOY | $869,605 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,813 | BOYAmt |
| EOY | $15,120 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $96,112 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $61,729 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,896 | BOYAmt |
| EOY | $34,383 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,355 | BOYAmt |
| EOY | $298,907 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,305,651 | BOYAmt |
| EOY | $25,918,318 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,175 | BOYAmt |
| EOY | $61,844 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,365,379 | BOYAmt |
| EOY | $30,571,940 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,575 | BOYAmt |
| EOY | $377,129 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,195 | BOYAmt |
| EOY | $111,202 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,616,961 | BOYAmt |
| EOY | $194,583 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,813,731 | BOYAmt |
| EOY | $682,914 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,029,610 | BOYAmt |
| EOY | $18,861,689 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,079,916 | BOYAmt |
| EOY | $9,538,303 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,442,122 | BOYAmt |
| EOY | $1,489,034 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,551,648 | BOYAmt |
| EOY | $29,889,026 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,365,379 | BOYAmt |
| EOY | $30,571,940 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,113,663 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,358,515 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$134,800 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,374,027 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,606,755 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,302,877 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,643,491 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,133,279 | CurrentTaxYearAmt |
| Total | $19,060,429 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,374,027 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,606,755 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,302,877 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,643,491 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,133,279 | CurrentTaxYearAmt |
| Total | $19,060,429 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $5,522,808 | SubstantialContributorsTotAmt |
| Public Support Total170 | $13,537,621 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $423,110 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $469,137 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $419,341 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $538,345 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $590,190 | CurrentTaxYearAmt |
| Total | $2,440,123 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,500,552 | TotalSupportAmt |
| Public Support CY170 | 0.62960 | PublicSupportCY170Pct |
| Public Support PY170 | 0.62790 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,522,043 | BeginningYearBalanceAmt |
| Contributions | $2,322,323 | ContributionsAmt |
| Investment Earnings Or Losses | $107,924 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,338,837 | GrantsOrScholarshipsAmt |
| Other Expenditures | $586,116 | OtherExpendituresAmt |
| End Year Balance | $11,027,337 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,601,362 | BeginningYearBalanceAmt |
| Contributions | $1,688,872 | ContributionsAmt |
| Investment Earnings Or Losses | -$149,890 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,539,028 | GrantsOrScholarshipsAmt |
| Other Expenditures | $79,273 | OtherExpendituresAmt |
| End Year Balance | $10,522,043 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,015,293 | BeginningYearBalanceAmt |
| Contributions | $2,315,209 | ContributionsAmt |
| Investment Earnings Or Losses | -$11,496 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,384,201 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,333,443 | OtherExpendituresAmt |
| End Year Balance | $10,601,362 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,854,601 | BeginningYearBalanceAmt |
| Contributions | $2,610,802 | ContributionsAmt |
| Investment Earnings Or Losses | $10,806 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,018,530 | GrantsOrScholarshipsAmt |
| Other Expenditures | $442,386 | OtherExpendituresAmt |
| End Year Balance | $11,015,293 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,528,186 | BeginningYearBalanceAmt |
| Contributions | $2,290,207 | ContributionsAmt |
| Investment Earnings Or Losses | $78,244 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $936,157 | GrantsOrScholarshipsAmt |
| Other Expenditures | $3,105,879 | OtherExpendituresAmt |
| End Year Balance | $9,854,601 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.13500 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.86500 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $96,112 | OtherCostOrOtherBasisAmt |
| Depreciation | $61,729 | DepreciationAmt |
| Book Value | $34,383 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $34,383 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | POOLED INVESTMENT FUND | Desc |
| Book Value | $25,918,318 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $25,918,318 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DISCOUNTED CHARITABLE GIFT ANNUITY CONTRACTS | Desc |
| Amt | $194,583 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $194,583 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | USES OF ORGANIZATION'S ENDOWMENT FUNDS: ESSENTIA HEALTH FOUNDATION'S ENDOWMENT FUNDS ARE ESTABLISHED BY DONOR DESIGNATED CONTRIBUTIONS AND SPENT IN ACCORDANCE TO DONOR WISHES. THESE FUNDS ARE USED TO FURTHER THE MISSION OF ESSENTIA HEALTH BY SUPPORTING ESSENTIA HEALTH ENTITIES, PATIENTS, AND COMMUNITIES ESSENTIA HEALTH SERVES. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | DINNER/AUCTION | Event1Nm |
| Gross Receipts Event1 | $51,353 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $2,872 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $48,481 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $35,324 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $14,725 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $500 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $2,501 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF EVENT | Event2Nm |
| Gross Receipts Event2 | $43,200 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $16,320 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $26,880 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $3,704 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $8,864 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $8,763 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $6,968 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 4 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $60,305 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $9,091 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $51,214 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $44,033 | NonCashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $100 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $17,943 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $800 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $3,599 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $154,858 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $28,283 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $126,575 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $83,061 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $100 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $41,532 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $10,063 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $13,068 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $147,824 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$21,249 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|---|---|---|---|---|
| ESSENTIA HEALTH | ||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 200360007 | 501(C)(3) | $37,949 | PROGRAM SUPPORT | |||
| ESSENTIA INSTITUTE OF RURAL HEALTH | ||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 271291124 | 501(C)(3) | $239,526 | PROGRAM SUPPORT | |||
| SMDC MEDICAL CENTER | ||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 411878730 | 501(C)(3) | $173,930 | PROGRAM SUPPORT | |||
| ST MARY'S MEDICAL CENTER | ||||||||||
| 407 E 3RD ST | DULUTH | MN | 55805 | 410695604 | 501(C)(3) | $350,196 | PROGRAM SUPPORT | |||
| THE DULUTH CLINIC LTD | ||||||||||
| 400 E 3RD ST | DULUTH | MN | 55805 | 410883623 | 501(C)(3) | $17,135 | PROGRAM SUPPORT | |||
| ST MARY'S HOSPITAL OF SUPERIOR | ||||||||||
| 3500 TOWER AVE | SUPERIOR | WI | 54880 | 411811073 | 501(C)(3) | $24,465 | PROGRAM SUPPORT | |||
| INNOVIS HEALTH LLC | ||||||||||
| 3000 32ND AVE S | FARGO | ND | 58103 | 261175213 | 501(C)(3) | $91,383 | PROGRAM SUPPORT | |||
| BRIDGES MEDICAL CENTER | ||||||||||
| 201 9TH ST W | ADA | MN | 56510 | 200479568 | 501(C)(3) | $20,654 | PROGRAM SUPPORT | |||
| GRACEVILLE HEALTH CENTER | ||||||||||
| 115 W 2ND ST | GRACEVILLE | MN | 56240 | 410726173 | 501(C)(3) | $20,338 | PROGRAM SUPPORT | |||
| ST MARY'S REGIONAL HEALTH CENTER | ||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 411620386 | 501(C)(3) | $38,020 | PROGRAM SUPPORT | |||
| ST MARY'S EMS | ||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 411805811 | 501(C)(3) | $7,250 | PROGRAM SUPPORT | |||
| ST JOSEPH'S MEDICAL CENTER | ||||||||||
| 523 N 3RD ST | BRAINERD | MN | 56401 | 410695602 | 501(C)(3) | $192,553 | PROGRAM SUPPORT | |||
| ST MARY'S HOSPITAL INC | ||||||||||
| PO BOX 137 | COTTONWOOD | ID | 83522 | 820226453 | 501(C)(3) | $100,000 | PROGRAM SUPPORT | |||
| INITIATIVE FOUNDATION | ||||||||||
| 405 FIRST ST SE | LITTLE FALLS | MN | 56345 | 363451562 | 501(C)(3) | $10,000 | PROGRAM SUPPORT | |||
| UNIVERSITY OF MINNESOTA FOUNDATION | ||||||||||
| 200 OAK STREET SE STE 500 | MINNEAPOLIS | MN | 55455 | 416042488 | 501(C)(3) | $7,000 | PROGRAM SUPPORT | |||
| BRIDGES OF HOPE | ||||||||||
| PO BOX 742 | BRAINERD | MN | 56401 | 721538846 | 501(C)(3) | $10,000 | PROGRAM SUPPORT | |||
| BRAINERD FAMILY YMCA | ||||||||||
| 602 OAK STREET | BRAINERD | MN | 56401 | 410693938 | 501(C)(3) | $21,257 | PROGRAM SUPPORT | |||
| CITY OF NISSWA | ||||||||||
| PO BOX 410 | NISSWA | MN | 56468 | 416005419 | CITY OF NISSWA | PROGRAM SUPPORT | $8,000 | FAIR MARKET VALUE | BIKE SHELTER AND FIX-IT STATION | |
| CROW WING COUNTY VICTIM SERVICES INC | ||||||||||
| 309 W WASHINGTON ST | BRAINERD | MN | 56401 | 411827519 | 501(C)(3) | $7,500 | PROGRAM SUPPORT | |||
| LUTHERAN SOCIAL SERVICES OF MINNESOTA | ||||||||||
| 2485 COMO AVE | ST PAUL | MN | 55108 | 410872993 | 501(C)(3) | $8,400 | PROGRAM SUPPORT | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 20 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|
| ASSIST ESSENTIA HEALTH PATIENTS & COMMUNITY | 3945 | $69,612 | $155,251 | FMV | VARIOUS ITEMS (MEDICAL SUPPLIES, GAS GIFT CARDS, CLOTHING, GROCERIES, ETC.) |
| REACH OUT & READ, BOOKS FOR PATIENTS | 1482 | $12,309 | FMV | BOOKS | |
| ASSIST ESSENTIA HEALTH EMPLOYEES IN FINANCIAL NEED | 86 | $42,008 | $1,992 | FMV | GIFT CARDS |
| SCHOLARSHIPS | 42 | $30,864 | |||
| GRIEF SUPPORT GROUP | 2 | $80 | FMV | BEREAVEMENT ROSES |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PROCEDURE FOR MONITORING THE USE OF GRANTS: ESSENTIA HEALTH FOUNDATION'S MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE. ALL DISBURSEMENTS ARE MADE IN ACCORDANCE WITH FUND DESIGNATION AND PURPOSE. GRANTS ARE MADE TO GOVERNMENT & NOT-FOR-PROFIT INSTITUTIONS OR ORGANIZATIONS, PRIMARILY TO MEMBERS OF THE ESSENTIA HEALTH SYSTEM AND AFFILIATED ORGANIZATIONS. DISBURSEMENTS MUST BE CONSISTENT WITH THE MISSION STATEMENT AND PURPOSE OF THE ESSENTIA HEALTH FOUNDATION AS STATED IN ITS ORGANIZATIONAL DOCUMENTS. GRANT PROPOSALS ARE REVIEWED AT VARIOUS ASSOCIATED FOUNDATION COMMITTEES PRIOR TO DISBURSEMENT AND IN ACCORDANCE WITH THE FUND DISBURSEMENT PROCESS. GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS IS USED TO ASSIST ESSENTIA HEALTH PATIENTS AND COMMUNITY MEMBERS IN FINANCIAL NEED; TO ASSIST WITH COMMUNITY BASED PROGRAMS TO INCLUDE SUPPLIES, PREVENTION, AWARENESS, SUPPORT GROUPS OR EDUCATIONAL ACTIVITIES; OR TO PROVIDE SCHOLARSHIPS FOR THOSE IN THE MEDICAL FIELD. GRANT MONITORING OF SUCH ACTIVITIES ARE IN ACCORDANCE WITH PROCEDURES DEFINED ABOVE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT ERICKSON MD | ||||||||||||||
| BOARD DIRECTOR | $0 | $518,706 | $0 | $0 | $0 | $2,711 | $0 | $21,600 | $0 | $35,061 | $0 | $578,078 | $0 | $0 |
| JAMES GARVEY | ||||||||||||||
| INTERIM EXECUTIVE DIRECTOR THRU 4/18 | $0 | $420,653 | $0 | $63,835 | $0 | $79,172 | $0 | $69,455 | $0 | $22,273 | $0 | $655,388 | $0 | $40,176 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH FOUNDATION'S CHIEF DEVELOPMENT OFFICER'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: JAMES GARVEY $72,772 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: JAMES GARVEY $47,855 |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 26 | ContributionCnt |
| Noncash Contributions Rpt F990 | $6,224 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $85 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $56,591 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
Collectibles CollectiblesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,330 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 115 | ContributionCnt |
| Noncash Contributions Rpt F990 | $15,298 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $500 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
Scientific Specimens ScientificSpecimensGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 6 | ContributionCnt |
| Noncash Contributions Rpt F990 | $535 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | AUCTION ITEMS | Desc |
| Contribution | 133 | ContributionCnt |
| Noncash Contributions Rpt F990 | $38,088 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | ESSENTIA HEALTH FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. SCHEDULE M, PART I, COLUMN (D): METHOD: ESSENTIA HEALTH FOUNDATION USED THE COST OR SELLING PRICE OF DONATED PROPERTY TO DETERMINE AMOUNT REPORTED ON FORM 990, PART VIII, LINE 1G. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 16A | PROFESSIONAL FUNDRAISING EXPENSES: THE AMOUNT LISTED REPRESENTS THE INTERNAL PROFESSIONAL FUNDRAISING COSTS AS REPORT ON PART IX, COLUMN (D), LINE 5. IT DOES NOT REPRESENT FEES PAID TO EXTERNAL PROFESSIONAL FUNDRAISERS. |
| FORM 990, PART V, LINE 1A | 1099 REPORTING: CERTAIN VENDOR PAYMENTS AND FORM 1099'S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF CERTAIN LEGAL ENTITIES COMPRISING ESSENTIA HEALTH. |
| FORM 990, PART V, LINE 1C | NO GAMING (GAMBLING) WINNINGS. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OF ORGANIZATION: ESSENTIA HEALTH IS THE SOLE MEMBER OF ESSENTIA HEALTH FOUNDATION AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. ESSENTIA HEALTH ALSO HAS RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH FOUNDATION AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBER WITH RIGHT TO ELECT GOVERNING BODY: ESSENTIA HEALTH APPOINTS AND REMOVES ESSENTIA HEALTH FOUNDATION'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISION: ESSENTIA HEALTH FOUNDATION IS A SUBSIDIARY OF ESSENTIA HEALTH, WHOSE BOARD OF DIRECTORS HAS RESERVED POWERS WITH RESPECT TO THIS CORPORATION AND ITS SUBSIDIARIES, AND ALL OF THE OTHER DIRECT AND INDIRECT SUBSIDIARIES OF ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). ESSENTIA HEALTH'S RESERVED POWERS ARE AS FOLLOWS: STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. DEBT. APPROVAL OF THE INCURRENCE OF DEBT BY, AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS AND/OR CERTIFICATES OF FORMATION AND OPERATING AGREEMENTS OF ALL ENTITIES IN THE SYSTEM. MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (A) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (B) FROM THE CATHOLIC ENTITIES TO THE SECULAR ENTITIES OR FROM THE SECULAR ENTITIES TO THE CATHOLIC ENTITIES IN A MANNER OR TO AN EXTENT THAT WOULD CAUSE THE CATHOLIC ENTITIES TO BE IN VIOLATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS) IN THE JUDGMENT OF THE LOCAL ORDINARY; OR (C) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. RESERVED POWERS. AUTHORITY TO CREATE ADDITIONAL ESSENTIA HEALTH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 80% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS (EXCLUDING THE ESSENTIA HEALTH CEO); PROVIDED, HOWEVER, THAT ANY ADDITIONAL ESSENTIA HEALTH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE RESERVED POWERS OF BENEDICTINE SISTERS BENEVOLENT ASSOCIATION. |
| FORM 990, PART VI, SECTION A, LINE 8B | COMMITTEES: THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE 2017 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY ESSENTIA HEALTH FOUNDATION'S MANAGEMENT AND GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2017 FORM 990. ESSENTIA HEALTH FOUNDATION'S FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE HIS/HER MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND IF APPROPRIATE, WITHDRAW, FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, HE OR SHE WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. |
| FORM 990, PART VI, SECTION B, LINE 15A | PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ESSENTIA HEALTH FOUNDATION'S CHIEF DEVELOPMENT OFFICER WAS 2018. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). |
| FORM 990, PART XI, LINE 9: | ADJUSTMENT FOR CHANGE IN VALUE OF CHARITABLE GIFT ANNUITY 34,299. UNCOLLECTIBLE PLEDGES -169,099. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BRAINERD LAKES INTEGRATED HEALTH SYSTEM | |||||||||||
| 2024 S 6TH ST | BRAINERD | MN | 56401 | 371532145 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12B, II | ESSENTIA HEALTH | Yes (1) | |
| BRAINERD MEDICAL CENTER INC | |||||||||||
| 2024 S 6TH ST | BRAINERD | MN | 56401 | 371532148 | CLINIC | MN | 501(C)(3) | LINE 3 | BRAINERD LAKES INTEGRATED HEALTH SYSTEM | Yes (1) | |
| BRIDGES MEDICAL CENTER | |||||||||||
| 201 9TH ST W | ADA | MN | 56510 | 200479568 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| CLEARWATER VALLEY HOSPITAL AND CLINICS INC | |||||||||||
| 301 CEDAR | OROFINO | ID | 83544 | 820497771 | HOSPITAL/CLINIC | ID | 501(C)(3) | LINE 3 | CRITICAL ACCESS GROUP | Yes (1) | |
| CRITICAL ACCESS GROUP | |||||||||||
| 503 E 3RD ST STE 400 | DULUTH | MN | 55805 | 261219624 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12B, II | ESSENTIA HEALTH | Yes (1) | |
| DEER RIVER HEALTHCARE CENTER INC | |||||||||||
| 115 10TH AVE NE | DEER RIVER | MN | 56636 | 410844574 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| ESSENTIA HEALTH | |||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 200360007 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |
| ESSENTIA INSTITUTE OF RURAL HEALTH | |||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 271291124 | RESEARCH | MN | 501(C)(3) | LINE 4 | THE DULUTH CLINIC LTD | Yes (1) | |
| FIRST CARE MEDICAL SERVICES | |||||||||||
| 900 HILLIGOSS BLVD SE | FOSSTON | MN | 56542 | 410706143 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| GRACEVILLE HEALTH CENTER | |||||||||||
| 115 W 2ND ST | GRACEVILLE | MN | 56240 | 410726173 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| INNOVIS HEALTH LLC | |||||||||||
| 3000 32ND AVE S | FARGO | ND | 58103 | 261175213 | HOSPITAL/CLINIC | DE | 501(C)(3) | LINE 3 | ESSENTIA HEALTH | Yes (1) | |
| MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC | |||||||||||
| 4418 HAINES RD | DULUTH | MN | 55811 | 411674021 | MEDICAL EQUIPMENT | MN | 501(C)(3) | LINE 10 | ST MARY'S MEDICAL CENTER | Yes (1) | |
| NORTHERN PINES MEDICAL CENTER | |||||||||||
| 5211 HWY 110 | AURORA | MN | 55705 | 410841441 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| PINE MEDICAL CENTER | |||||||||||
| 705 LUNDORFF DR S | SANDSTONE | MN | 55072 | 411884597 | HOSPITAL | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| POLINSKY MEDICAL REHABILITATION CENTER | |||||||||||
| 530 E 2ND ST | DULUTH | MN | 55805 | 410691275 | REHABILITATION SERVICES | MN | 501(C)(3) | LINE 3 | ST MARY'S MEDICAL CENTER | Yes (1) | |
| SMDC MEDICAL CENTER | |||||||||||
| 502 E 2ND ST | DULUTH | MN | 55805 | 411878730 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| ST JOSEPH'S MEDICAL CENTER | |||||||||||
| 523 N 3RD ST | BRAINERD | MN | 56401 | 410695602 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | BRAINERD LAKES INTEGRATED HEALTH SYSTEM | Yes (1) | |
| ST MARY'S DULUTH CLINIC HEALTH SYSTEM | |||||||||||
| 407 E 3RD ST | DULUTH | MN | 55805 | 411836633 | SUPPORTING ORG | MN | 501(C)(3) | LINE 12B, II | ESSENTIA HEALTH | Yes (1) | |
| ST MARY'S EMS | |||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 411805811 | EMERGENCY SERVICES | MN | 501(C)(3) | LINE 10 | INNOVIS HEALTH LLC | Yes (1) | |
| ST MARY'S HOSPITAL OF SUPERIOR | |||||||||||
| 3500 TOWER AVE | SUPERIOR | WI | 54880 | 411811073 | HOSPITAL/CLINIC | MN | 501(C)(3) | LINE 3 | ST MARY'S MEDICAL CENTER | Yes (1) | |
| ST MARY'S HOSPITAL INC | |||||||||||
| PO BOX 137 | COTTONWOOD | ID | 83522 | 820226453 | HOSPITAL/CLINIC | ID | 501(C)(3) | LINE 3 | CRITICAL ACCESS GROUP | Yes (1) | |
| ST MARY'S INNOVIS HEALTH | |||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 262861321 | PHARMACY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| ST MARY'S MEDICAL CENTER | |||||||||||
| 407 E 3RD ST | DULUTH | MN | 55805 | 410695604 | HOSPITAL | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
| ST MARY'S REGIONAL HEALTH CENTER | |||||||||||
| 1027 WASHINGTON AVE | DETROIT LAKES | MN | 56501 | 411620386 | HOSPITAL/CLINIC/SKILLED NURSING FACILITY | MN | 501(C)(3) | LINE 3 | INNOVIS HEALTH LLC | Yes (1) | |
| THE DULUTH CLINIC LTD | |||||||||||
| 400 E 3RD ST | DULUTH | MN | 55805 | 410883623 | CLINIC | MN | 501(C)(3) | LINE 3 | ST MARY'S DULUTH CLINIC HEALTH SYSTEM | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PMC-GATEWAY IMAGING LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 LUNDORFF DR S | AddressLine1Txt |
| City | SANDSTONE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55072 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261634764 | EIN |
| Primary Activities | IMAGING SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ESSENTIA HEALTH INSURANCE SERVICES SPC LTD | BusinessNameLine1Txt |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1159 | AddressLine1Txt |
| City | GRAND CAYMAN | CityNm |
| Country | CJ | CountryCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 000000000 | EIN |
| Primary Activities | SELF INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (13 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ESSENTIA HEALTH | ||
| P | $101,233 | ACTUAL COSTS |
| ESSENTIA HEALTH | ||
| S | $212,357 | ACTUAL COSTS |
| ESSENTIA INSTITUTE OF RURAL HEALTH | ||
| B | $239,526 | ACTUAL COSTS |
| INNOVIS HEALTH LLC | ||
| B | $91,383 | ACTUAL COSTS |
| INNOVIS HEALTH LLC | ||
| C | $269,869 | ACTUAL COSTS |
| SMDC MEDICAL CENTER | ||
| B | $173,930 | ACTUAL COSTS |
| SMDC MEDICAL CENTER | ||
| S | $56,445 | ACTUAL COSTS |
| ST JOSEPH'S MEDICAL CENTER | ||
| B | $192,553 | ACTUAL COSTS |
| ST JOSEPH'S MEDICAL CENTER | ||
| C | $128,476 | ACTUAL COSTS |
| ST MARY'S HOSPITAL INC | ||
| B | $100,000 | ACTUAL COSTS |
| ST MARY'S MEDICAL CENTER | ||
| B | $350,196 | ACTUAL COSTS |
| ST MARY'S MEDICAL CENTER | ||
| C | $265,047 | ACTUAL COSTS |
| ST MARY'S REGIONAL HEALTH CENTER | ||
| C | $209,147 | ACTUAL COSTS |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, COLUMN (A) | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING ESSENTIA HEALTH ENTITIES HAVE A DOING BUSINESS AS NAME: LEGAL NAME; DOING BUSINESS AS NAME BRAINERD LAKES INTEGRATED HEALTH SYSTEM; ESSENTIA HEALTH CENTRAL BRAINERD MEDICAL CENTER, INC.; ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC BRIDGES MEDICAL CENTER; ESSENTIA HEALTH ADA DEER RIVER HEALTHCARE CENTER, INC.; ESSENTIA HEALTH DEER RIVER FIRST CARE MEDICAL SERVICES; ESSENTIA HEALTH FOSSTON GRACEVILLE HEALTH CENTER; ESSENTIA HEALTH HOLY TRINITY HOSPITAL INNOVIS HEALTH, LLC; ESSENTIA HEALTH WEST MIDWEST MEDICAL EQUIPMENT AND SUPPLIES, INC.; ESSENTIA HEALTH MEDICAL EQUIPMENT & SUPPLIES NORTHERN PINES MEDICAL CENTER; ESSENTIA HEALTH NORTHERN PINES PINE MEDICAL CENTER; ESSENTIA HEALTH SANDSTONE POLINSKY MEDICAL REHABILITATION CENTER; ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER SMDC MEDICAL CENTER; ESSENTIA HEALTH DULUTH ST. JOSEPH'S MEDICAL CENTER; ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ST. MARY'S DULUTH CLINIC HEALTH SYSTEM; ESSENTIA HEALTH EAST ST. MARY'S EMS; ESSENTIA HEALTH ST. MARY'S EMERGENCY MEDICAL SERVICES-DETROIT LAKES ST. MARY'S HOSPITAL OF SUPERIOR; ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR ST. MARY'S MEDICAL CENTER; ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER ST. MARY'S REGIONAL HEALTH CENTER; ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES | ExplanationTxt |
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