CENTRAL MINNESOTA DIAGNOSTIC INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL MINNESOTA DIAGNOSTIC INC (EIN 36-3397264)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-08-14
- IRS object ID
- 201912269349301856
- Schema version
- 2018v3.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-08-14T13:04:13-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRVIEW HEALTH SVCS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2450 RIVERSIDE AVE S DEPT C-207 LE | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554541450 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363397264 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL MINNESOTA DIAGNOSTIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3209836300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 - 10TH STREET NW P O BOX 158 | AddressLine1Txt |
| City | MILACA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563531221 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHAD COOPER | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 3209836300 | PhoneNum |
| Signature | 2019-08-14 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparation | 2019-08-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 162.96.9.40 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-08-14 | IPDt |
| IP Tm | 13:04:13 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9A7795162CD8FED1DB572D6341B886463E8B285F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9A7795162CD8FED1DB572D6341B886463E8B285F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHAD COOPER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 - 10TH STREET NW PO BOX 158 | AddressLine1Txt |
| City | MILACA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563531221 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $39,669,732 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CMDI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE DIAGNOSTIC SERVICES TO CERTAIN SECTION 501(C)(3) HOSPITAL ORGANIZATIONS ENGAGING IN HEALTHCARE ACTIVITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 34 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 30 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,270,033 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $39,390,989 | CYProgramServiceRevenueAmt |
| PY Investment Income | $570,916 | PYInvestmentIncomeAmt |
| CY Investment Income | $232,810 | CYInvestmentIncomeAmt |
| PY Other Revenue | $64,021 | PYOtherRevenueAmt |
| CY Other Revenue | $1,920 | CYOtherRevenueAmt |
| PY Total Revenue | $39,904,970 | PYTotalRevenueAmt |
| CY Total Revenue | $39,625,719 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,196,727 | PYOtherExpensesAmt |
| CY Other Expenses | $28,256,651 | CYOtherExpensesAmt |
| PY Total Expenses | $28,196,727 | PYTotalExpensesAmt |
| CY Total Expenses | $28,256,651 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,708,243 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,369,068 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $47,772,779 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,088,276 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,711,719 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,105,148 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $35,061,060 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $37,983,128 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE DIAGNOSTIC SERVICES TO CERTAIN SECTION 501(C)(3) HOSPITAL ORGANIZATIONS ENGAGING IN HEALTHCARE ACTIVITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $27,012,445 | ExpenseAmt |
| Revenue | $39,390,987 | RevenueAmt |
| Desc | CENTRAL MINNESOTA DIAGNOSTIC INC. PROVIDES HOSPITAL INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES. IN 2018, THE ORGANIZATION PERFORMED 262,942 ULTRASOUD, MAMMOGRAPHY, CT SCANNER, NUCLEAR MEDICINE, BONE DENSITOMETRY AND MRI PROCEDURES. | Desc |
| Total Program Service Expenses | $27,012,445 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 34 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 30 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHAD COOPER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3209836327 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 - 10TH STREET NW P O BOX 158 | AddressLine1Txt |
| City | MILACA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563531221 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| PATRICK SHARP | ||||||||
| DIRECTOR | 0.50 | 40.00 | Yes (X) | $0 | $440,383 | $59,138 | ||
| KAREN WHILEY | ||||||||
| DIRECTOR | 0.50 | 40.00 | Yes (X) | $0 | $253,305 | $66,064 | ||
| CHAD COOPER | ||||||||
| PRESIDENT/CE | 0.50 | 40.00 | Yes (X) | $0 | $240,099 | $39,826 | Yes (X) | |
| RANDY ULSETH | ||||||||
| CHAIRMAN | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RICK BREUER | ||||||||
| VICE CHAIR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MICHAEL HEDRIX | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| AARON SAUDE | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KYLE BAUER | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRANDON PIETSCH | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DEL CHRISTIANSON | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BEN KOPPELMAN | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHUCK HOFIUS | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KIRK STENSRUD | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARYELLEN WELLS | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TIM RICE | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARSHA GREEN | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GERRY GILBERTSON | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAN SWENSON | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID NELSON | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BILL NELSON | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOEL BEISWENGER | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHELSIE FALK | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM LYONS | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KURT WALDBILLIG | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TERESA DEBEVEC | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBB PASTOR | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE SMITH | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TODD SANDBERG | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRYAN LYDICK | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRYAN BAUCK | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RICK ASH | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRAD BURRIS | ||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GLENN ERICKSON | ||||||||
| FORMER PRES/ | 0.50 | 40.00 | $0 | $500,960 | $66,624 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $1,434,747 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $231,652 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | Address Line2ContractorAddress/USAddress/AddressLine2Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| SIEMENS | ||||||
| DEPT CH 14195 | DEPT CH 14195 | PALATINE | IL | 600554195 | REPAIR/MAINT | $2,863,951 |
| DELTA MEDICAL SYSTEMS | ||||||
| 3280 GATEWAY ROADE SUITE 200 | 3280 GATEWAY ROAD SUITE 200 | BROOKFIELD | WI | 53045 | REPAIR/MAINT | $2,633,606 |
| GE PRECISION HEALTHCARE LLS | ||||||
| PO BOX 96483 | PO BOX 96483 | CHICAGO | IL | 60693 | REPAIR/MAINT | $1,563,768 |
| NORTHERN IMAGING | ||||||
| 2118 FOURTH AVENUE SOUTH | 2118 FOURTH AVENUE SOUTH | MINNEAPOLIS | MN | 554042642 | REPAIR/MAINT | $1,044,464 |
| PHILIPS HEALTHCARE | ||||||
| PO BOX 100355 | PO BOX 100355 | ATLANTA | GA | 303840355 | REPAIR/MAINT | $304,660 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DIAGNOSTIC SERVICES | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $39,390,989 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,390,989 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $39,390,989 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $236,643 | TotalRevenueColumnAmt |
| Exclusion | $236,643 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $40,180 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $44,013 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$3,833 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,833 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$3,833 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC | Desc |
| Total Revenue Column | $1,920 | TotalRevenueColumnAmt |
| Exclusion | $1,920 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,920 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,625,719 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,387,156 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $238,563 | ExclusionAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,494,039 | TotalAmt |
| Program Services | $6,541,667 | ProgramServicesAmt |
| Management And General | $952,372 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359 | TotalAmt |
| Program Services | $359 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,880 | TotalAmt |
| Management And General | $40,880 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,215 | TotalAmt |
| Program Services | $90,492 | ProgramServicesAmt |
| Management And General | $117,723 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,559 | TotalAmt |
| Program Services | $3,120 | ProgramServicesAmt |
| Management And General | $25,439 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,281 | TotalAmt |
| Program Services | $100,779 | ProgramServicesAmt |
| Management And General | $10,502 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,213 | TotalAmt |
| Management And General | $3,213 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,399 | TotalAmt |
| Program Services | $78,532 | ProgramServicesAmt |
| Management And General | $19,867 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,951 | TotalAmt |
| Program Services | $464,121 | ProgramServicesAmt |
| Management And General | $37,830 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352,081 | TotalAmt |
| Program Services | $352,081 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,432,436 | TotalAmt |
| Program Services | $9,414,223 | ProgramServicesAmt |
| Management And General | $18,213 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,255 | TotalAmt |
| Program Services | $208,740 | ProgramServicesAmt |
| Management And General | $515 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS | $9,191,893 | $9,189,227 | $2,666 |
| SUPPLIES | $529,149 | $525,961 | $3,188 |
| PROFESSIONAL | $46,613 | $39,748 | $6,865 |
| MISCELLANEOUS | $6,103 | $1,195 | $4,908 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,225 | TotalAmt |
| Program Services | $2,200 | ProgramServicesAmt |
| Management And General | $25 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,256,651 | TotalAmt |
| Program Services | $27,012,445 | ProgramServicesAmt |
| Management And General | $1,244,206 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,221,468 | BOYAmt |
| EOY | $4,964,878 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $850,200 | BOYAmt |
| EOY | $335,093 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,172,294 | BOYAmt |
| EOY | $5,437,388 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $868,083 | BOYAmt |
| EOY | $857,568 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $112,115,216 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $84,606,756 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,936,640 | BOYAmt |
| EOY | $27,508,460 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,724,094 | BOYAmt |
| EOY | $7,984,889 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,772,779 | BOYAmt |
| EOY | $47,088,276 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,977,597 | BOYAmt |
| EOY | $2,159,340 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,734,122 | BOYAmt |
| EOY | $6,945,808 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,711,719 | BOYAmt |
| EOY | $9,105,148 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,061,060 | BOYAmt |
| EOY | $37,983,128 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,061,060 | BOYAmt |
| EOY | $37,983,128 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,772,779 | BOYAmt |
| EOY | $47,088,276 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $11,369,068 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$479,580 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$7,967,420 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,500 | OtherCostOrOtherBasisAmt |
| Book Value | $13,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $334,381 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,843 | DepreciationAmt |
| Book Value | $322,538 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $111,767,335 | OtherCostOrOtherBasisAmt |
| Depreciation | $84,594,913 | DepreciationAmt |
| Book Value | $27,172,422 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $27,508,460 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $39,146,139 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$479,580 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$479,580 | RevenueNotReportedAmt |
| Revenue Subtotal | $39,625,719 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $39,625,719 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,256,651 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $28,256,651 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $28,256,651 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XIII | FormAndLineReferenceDesc |
| Explanation | ALL SERVICES OF THE COMPANY QUALIFY AS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THESE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|
| PATRICK SHARP | ||||||
| DIRECTOR | $440,383 | $22,979 | $36,159 | $499,521 | ||
| KAREN WHILEY | ||||||
| DIRECTOR | $227,896 | $24,500 | $41,564 | $319,369 | $25,409 | |
| CHAD COOPER | ||||||
| PRESIDENT/CEO | $240,099 | $25,592 | $14,234 | $279,925 | ||
| GLENN ERICKSON | ||||||
| FORMER PRES/CEO | $241,709 | $24,500 | $42,124 | $567,584 | $258,391 | $860 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V | LINE 2A - CENTRAL MINNESOTA DIAGNOSTIC INC. LEASES EMPLOYEES FROM AN AFFILIATED ORGANIZATION, FAIRVIEW HEALTH SERVICES, A 501(C)(3) TAX-EXEMPT, NON-PROFIT ORGANIZATION. THEREFORE, FAIRVIEW HEALTH SERVICES FILES THE APPROPRIATE W-3 AND RELATED W-2 TAX FORMS FOR THESE INDIVIDUALS INSTEAD OF CENTRAL MINNESOTA DIAGNOSTIC INC. |
| FORM 990, PAGE 6, PART VI, LINE 3 | CENTRAL MINNESOTA DIAGNOSTIC, INC. CONTRACTS WITH FAIRVIEW HEALTH SERVICES TO MANAGE A VARIETY OF ACCOUNTING AND FINANCIAL DUTIES. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE MEMBERS CONSIST OF THOSE ENTITIES THAT UTILIZE THE SERVICES OF CENTRAL MINNESOTA DIAGNOSTICS SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THOSE ELECTED ARE BASED ON PARTICIPATION. THOSE ON THE BOARD ARE REPRESENTATIVE OF THOSE UTILIZING THE SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PREPARED AND REVIEWED BY FAIRVIEW HEALTH SERVICES TAX DEPARTMENT. IT IS THEN REVIEWED BY CMDI'S FINANCIAL OPERATIONS SPECIALIST AND CEO. THE FORM 990 IS AVAILABLE TO BOARD MEMBERS AT THEIR REQUEST. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICT OF INTEREST SURVEYS ARE COMPLETED AND REVIEWED BY THE BOARD AND ANY POSIBLE ISSUE IS RESOLVED. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE PRESIDENT OF CENTRAL MINNESOTA DIAGNOSTIC, INC. RECEIVES HIS SALARY AS A VICE PRESIDENT OF FAIRVIEW HEALTH SERVICES AND IS SUBJECT TO FAIRVIEW'S COMPENSTION DETERMINATION PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE PRESIDENT OF CENTRAL MINNESOTA DIAGNOSTIC, INC. RECEIVES HIS SALARY AS A VICE PRESIDENT OF FAIRVIEW HEALTH SERVICES AND IS SUBJECT TO FAIRVIEW'S COMPENSTION DETERMINATION PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | CENTRAL MINNESOTA DIAGNOSTIC, INC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND INSPECTION OF THE DOCUMENTS IS AVAILABLE AT THE CORPORATE FINANCE DEPARTMENT. |
| FORM 990, PART XI, LINE 9 | DISTRIBUTION TO MEMBER ORGANIZATIONS -7,967,420 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRVIEW HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2450 RIVERSIDE AVENUE | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55454 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410991680 | EIN |
| Primary Activities | HEALTH CAR | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FAIRVIEW HEALTH SERVICES | ||
| O | $7,479,345 | COST |
| FAIRVIEW HEALTH SERVICES | ||
| Q | $73,000 | COST |
| FAIRVIEW HEALTH SERVICES | ||
| J | $5,197,396 | COST |
| FAIRVIEW HEALTH SERVICES | ||
| M | $71,600 | COST |
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