2018-11-13T09:44:37-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-01-01 274116873 ALLINA ASSOCIATED FOUNDATION ALLI 6122620660 PO BOX 43 MR 10890 MINNEAPOLIS MN 554400043 RICHARD E MAGNUSON CHIEF FINANCIAL OFFICER 6122620660 2018-10-30 1 KAREN GRIES P00078514 6123764500 67.137.57.251 2018-10-30 16:22:06 CD P 215EDC34B90BB792BE41535AC625FFE995AEE0DF 18794D93E6043908D9C9A4CBEB9D5665E7590A55 2017 2019-02-21 02:37:17Z STEPHEN BARITEAU PO BOX 43 MR 10890 MINNEAPOLIS MN 554400043 8752678 0 X SEE STATEMENT X 2010 MN TO RAISE, STEWARD AND DISTRIBUTE PHILANTHROPIC FUNDS IN SUPPORT OF BUFFALO HOSPITAL, CAMBRIDGE MEDICAL CENTER, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, RIVER FALLS AREA HOSPITAL, ALLINA HEALTH HOME CARE SERVICES AND PENNY GEORGE INSTITUTE OF HEALTH & HEALING. 16 6 0 151 0 0 3983430 4000686 0 0 73514 89310 58170 116912 4115114 4206908 2155391 2425550 0 0 0 0 25514 23987 1077089 1529317 1626390 3710222 4075927 404892 130981 7331937 7452937 78422 71920 7253515 7381017 X THE MISSION OF ALLINA ASSOCIATED FOUNDATION IS TO RAISE, STEWARD AND DISTRIBUTE PHILANTHROPIC FUNDS IN SUPPORT OF BUFFALO HOSPITAL, CAMBRIDGE MEDICAL CENTER, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, RIVER FALLS AREA HOSPITAL, ALLINA HEALTH HOME CARE SERVICES AND PENNY GEORGE INSTITUTE FOR HEALTH & HEALING. THE FOUNDATION IS A SEPARATE NOT-FOR-PROFIT ENTITY DEDICATED TO SUPPORTING THE HOSPITALS, ALLINA HEALTH HOME CARE SERVICES PROGRAM AND PENNY GEORGE INSTITUTE FOR HEALTH & HEALING AND IS GOVERNED BY A SEPARATE BOARD. 0 0 1699018 1699018 0 HOSPITAL AND MEDICAL CENTER GENERAL OPERATIONS:OPERATIONAL GRANTS ARE USED TO SUPPORT A MULTITUDE OF PROGRAMS INCLUDING RESEARCH, BIRTH, HEART, LITERACY AND INTEGRATIVE THERAPY PROGRAMS. THESE PROGRAMS WERE ESTABLISHED TO SUPPORT THE PATIENTS AND COMMUNITIES OF BUFFALO HOSPITAL, CAMBRIDGE MEDICAL CENTER, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, RIVER FALLS AREA HOSPITAL, ALLINA HEALTH HOME CARE SERVICES AND PENNY GEORGE INSTITUTE FOR HEALTH & HEALING. 562380 562380 0 THE FOLLOWING ARE SOME EXAMPLES OF EXTERNAL PROGRAMS SUPPORTED IN 2017: NEW ULM MEDICAL CENTER COURAGE KENNY REHABILITATION INSTITUTE REMODEL: $220,850THIS GRANT WAS USED TO EXPAND AND RENOVATE NEW ULM MEDICAL CENTER'S COURAGE KENNY REHABILITATION INSTITUTE. INCLUDED IN AN INCREASE IN OVERALL SPACE, NEW ROOM WITH SEPARATE SPACES FOR ADULT AND CHILD REHAB, A COURAGE KENNY KIDS PROGRAM, GYM EXPANSION, PRIVATE TREATMENTS AREAS AND ADDITIONAL OFFICE SPACE.NEW ULM MEDICAL CENTER LARYNGOSCOPE: $29,578THIS GRANT WAS USED TO PURCHASE A GLIDESCOPE SYSTEM FOR NEW ULM MEDICAL CENTER. IT WILL ALLOW FOR VIDEO-SCOPIC VISUALIZATION OF AIRWAYS TO ASSIST IN INTUBATION OF PATIENTS. CAPABLE TO BE USED IN PATIENTS DOWN TO THREE POUNDS, THIS SYSTEM WILL EXPAND GLIDESCOPE USE TO NEONATE EMERGENT SITUATIONS, LESSENING THE RISK OF BRAIN DAMAGE AND DEATH IN THESE PATIENTS. BUFFALO MEDICAL CENTER PENNY GEORGE INSTITUTE FOR HEALTH & HEALING (IHH): $106,484THIS GRANT WAS USED TO OPEN A PENNY GEORGE INSTITUTE FOR HEALTH & HEALING AT THE BUFFALO CAMPUS, BRINGING INTEGRATIVE MEDICINE OPTIONS AND OPPORTUNITIES TO THE COMMUNITY. THE PENNY GEORGE IHH SITE OFFERS ACUPUNCTURE, NUTRITION COUNSELING AND INTEGRATIVE MEDICINE CONSULTS.BUFFALO MEDICAL CENTER BREAST CARE: $194,997THIS GRANT FACILITATED THE PURCHASE AND INSTALL OF A 3D MAMMOGRAPHY UNIT IN NOVEMBER OF 2017. BRINGING 3D MAMMOGRAPHY TO THE BUFFALO HOSPITAL CAMPUS ADDS POTENTIAL FOR STEREOTACTIC BIOPSY PROCEDURES IN THE FUTURE.$10,471 IN ADDITIONAL CAPITAL GRANTS WERE PROVIDED TO SUPPORT VARIOUS INDIVIDUAL PROJECTS 65969 65969 0 THE FOLLOWING ARE SOME EXAMPLES OF EXTERNAL PROGRAMS SUPPORTED IN 2017:$13,469 WAS PROVIDED TO THE FREE CLINIC OF PIERCE AND ST. CROIX COUNTIES. GRANTS WERE GIVEN TO SUPPORT GENERAL CLINIC OPERATIONS. SINCE 2007, THE CLINIC HAS BEEN PROVIDING FREE PRIMARY HEALTH CARE TO LOW-INCOME, UNINSURED RESIDENTS OF PIERCE AND ST. CROIX COUNTIES IN WESTERN WISCONSIN.$50,000 WAS PROVIDED TO MINNEAPOLIS HEART INSTITUTE FOUNDATION TO SUPPORT THE HEART OF NEW ULM PROGRAM. FUNDS WILL BE USED LOCALLY AND WILL WORK ON STRATEGIES SUCH AS HIGH RISK POPULATIONS, HEALTH CARE, WORKSITE TRAININGS, FOOD ENVIRONMENT, POLICY/SYSTEMS, COMMUNICATIONS AND COMMUNITY CAPACITY TRAINING.$2,500 WAS PROVIDED TO VOLUNTEERS OF AMERICA TO FUND THE PURCHASE OF A NEW BUS. 98183 98183 0 HOUSING/LIVING, MEDICAL, AND EDUCATIONAL ASSISTANCE TO CO-WORKERS AND PATIENTS - $98,183. THE FOLLOWING ARE SOME EXAMPLES OF HOSPITAL AND MEDICAL CENTER PROGRAMS SUPPORTING INDIVIDUAL PATIENTS AND EMPLOYEES:BUFFALO HOSPITAL'S HOPE FUND AND CANCER CARE FUND OFFER EMERGENCY FINANCIAL ASSISTANCE TO HELP WITH EXPENSES DURING BREAST CANCER CARE AND TREATMENT. $46,617 IN ASSISTANCE WAS PROVIDED IN 2017.BUFFALO HOSPITAL'S CARING FOR COWORKERS PROVIDES CONFIDENTIAL EMERGENCY ASSISTANCE TO HOSPITAL EMPLOYEES WHO SUFFER SUDDEN ECONOMIC HARDSHIP AND ARE STRUGGLING TO PAY MEDICAL BILLS, RENT AND OTHER EVERYDAY EXPENSES. $6,222 IN ASSISTANCE WAS PROVIDED IN 2017.BUFFALO AND NEW ULM PROVIDED $13,000 AND $13,000 RESPECTIVELY IN EDUCATIONAL SCHOLARSHIPS IN 2017.OWATONNA PROVIDED $2,478 TO SUPPORT THE EMPLOYEE EMERGENCY FUND.RIVER FALLS PROVIDED $16,866 TO SUPPORT CANCER PATIENT ASSISTANCE AND EDUCATIONAL SCHOLARSHIPS. 98183 98183 0 2425550 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 X 1 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0 X 16 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN WI X TAX SERVICES MR 10890 6122620660 2925 CHICAGO AVENUE MINNEAPOLIS MN 554071321 DAVID ALBRECHT DIRECTOR 2.00 40.00 X 0 274539 67300 COURTNEY BAECHLER MD DIRECTOR 2.00 40.00 X 0 542432 99514 DENISE BLIZIL DIRECTOR 2.00 0.00 X 0 0 0 JULIA CRIST DIRECTOR 2.00 40.00 X 0 191017 51162 ANGELA FAHMY DIRECTOR/TREASURER 2.00 0.00 X 0 0 0 TOBY FREIER DIRECTOR 2.00 40.00 X 0 359839 86567 DAVID MILLER DIRECTOR 2.00 40.00 X 0 307681 64987 JENNIFER MYSTER DIRECTOR 2.00 40.00 X 0 366003 66720 GAYLE OBER DIRECTOR 2.00 0.00 X 0 0 0 GARY SHAW DIRECTOR 2.00 40.00 X 0 456988 62719 PAUL SMITH DIRECTOR 2.00 0.00 X 0 0 0 DAVID STURGES DIRECTOR 2.00 0.00 X 0 0 0 ERIC WILTROUT DIRECTOR 2.00 0.00 X 0 0 0 STEPHEN BARITEAU DIRECTOR/PRESIDENT 2.00 40.00 X X 0 308753 66037 KATHLEEN BACKER DIRECTOR/SECRETARY 2.00 0.00 X 0 0 0 PATRICIA HACKMAN DIRECTOR/TREASURER 2.00 40.00 X 0 38592 28669 JENNIFER O'NEILL DIRECTOR/CHAIR 2.00 0.00 X 0 0 0 RICHARD MAGNUSON CFO 2.00 40.00 X 0 651816 170586 JAN MALCOLM FORMER DIRECTOR/FORMER PRESIDENT 0.00 2.00 X 0 377369 3258 DUNCAN GALLAGHER FORMER CFO 2.00 40.00 X 0 584817 25162 0 4459846 792681 0 1 1 0 0 17293 428057 1316533 2238803 27224 4000686 134026 134026 4338066 4382782 -44716 -44716 -44716 242300 428057 162888 79412 79412 37600 100 37500 37500 4206908 0 0 206222 2327366 2327366 98184 98184 9445 9445 23987 23987 67083 21788 45295 922 240 682 140338 36488 103850 7573 1969 5604 41704 10843 30861 2272 591 1681 STAFF SERVICES 909708 236524 673184 PURCH SVCS-AFFILIATES 201071 201071 0 ORIGINAL FUNDRAISING CO 133058 133058 BAD DEBT EXPENSES 50000 50000 63216 4329 58887 4075927 2425550 573288 1077089 364862 185744 6489329 6803137 477746 464056 7331937 7452937 78422 71920 78422 71920 X 3992908 4485433 3260607 2895584 7253515 7381017 7331937 7452937 X 130981 8447 -11926 X X 0 1 X 1 0 X X 1 ALLINA HEALTH SYSTEM 363261413 3 1 2261398 0 1 2261398 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 PART IV, SECTION A, LINE 6: FROM TIME TO TIME ALLINA ASSOCIATED FOUNDATION SUPPORTS OTHER NON-PROFIT 501(C)(3) ORGANIZATIONS OR NON-PROFIT GOVERNMENTAL ORGANIZATION THAT SUPPORT AND OR CARRY OUT THE MISSION, VISION AND VALUES OF ALLINA HEALTH SYSTEM AND THEIR COMMITMENT TO PATIENTS AND THE COMMUNITIES SERVED. ALLINA HEALTH SYSTEM IS THE SUPPORTED ORGANIZATION OF ALLINA ASSOCIATED FOUNDATION. PLEASE SEE SCHEDULE I, PART II, GRANTS AND OTHER ASSISTANCE TO DOMESTIC ORGANIZATIONS AND DOMESTIC GOVERNMENTS, FOR ORGANIZATIONS SUPPORTED BY ABBOTT NORTHWESTER HOSPITAL FOUNDATION THAT ARE ORGANIZED TO CARRY OUT OR SUPPORT THE PURPOSES, VALUES AND VISION OF ALLINA HEALTH SYSTEM. PART IV, SECTION B, LINE 2: FROM TIME TO TIME ALLINA ASSOCIATED FOUNDATION SUPPORTS OR PROVIDES BENEFIT TO OTHER NON-PROFIT 501(C)(3) ORGANIZATIONS OR NON-PROFIT GOVERNMENTAL ORGANIZATIONS THAT SUPPORT AND OR CARRY OUT THE MISSION, VISION AND VALUES OF ALLINA HEALTH SYSTEM, THE SUPPORTED ORGANIZATION, AND THEIR COMMITMENT TO PATIENTS AND THE COMMUNITIES SERVED. PLEASE SEE SCHEDULE I, PART II, GRANTS AND OTHER ASSISTANCE TO DOMESTIC ORGANIZATIONS AND DOMESTIC GOVERNMENT, FOR ORGANIZATIONS BENEFITED BY ALLINA ASSOCIATED FOUNDATION THAT ARE OPERATED TO CARRY OR SUPPORT THE PURPOSES, VALUES AND VISION OF ALLINA HEALTH SYSTEM AND SUPPORT ALLINA'S CARE CONTINUUM OF SERVICES, INCLUDING MEDICAL REHABILITATION, COMMUNITY BASED HEALTH AND WELLNESS SERVICES, ADVOCACY, RESEARCH AND INNOVATION AND ACT IN THE BEST INTEREST OF THE PATIENTS AND COMMUNITIES ALLINA HEALTH SYSTEM IS COMMITTED TO SERVE. 0 CASH EQUIVALENTS 38283 F FIXED INCOME SECURITIES 6500059 F EQUITY SECURITIES 30501 F FUNDS OF HEDGE FUNDS 33672 F MONEY MARKET 78724 F COMMODITIES AND OTHER 98395 F REAL RETURN MUTUAL FUNDS 23503 F 6803137 CHARITABLE REMAINDER TRUST 116918 DUE FROM ALLINA HEALTH SYSTEM 347138 464056 CHARITABLE REMAINDER TRUSTS BENEFICIARIES PAYABLE 71920 71920 X 4203429 8447 -11926 -3479 4206908 0 4206908 4075927 0 4075927 0 4075927 PART X, LINE 2: ALLINA ASSOCIATED FOUNDATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IT IS CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THEREFORE, CHARITABLE CONTRIBUTIONS ARE TAX DEDUCTIBLE. THE FOUNDATION HAS ADOPTED GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION OF UNCERTAIN TAX POSITIONS. THE GUIDANCE PRESCRIBES RECOGNITION THRESHOLD PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX FILING THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THIS GUIDANCE HAD NO IMPACT ON THE FOUNDATION'S FINANCIAL STATEMENTS. THE FOUNDATION'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE FOUNDATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. THE FOUNDATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -11,926. X X X X X X X 1 RUFFALO NOEL LEVITZ 1025 KIRKWOOD PARKWAY SW CEDAR RAPIDS IA 52404 TELEFUNDRAISING 0 20838 23987 -2249 20838 23987 -2249 MN WI DRAGONFLY GALA 222224 170738 51486 858 0 195 24925 375 14981 SPRING TONIC BUFFALO GALA 128280 69984 58296 0 2991 3198 12825 1100 19397 7 319853 187335 132518 0 6269 4620 26421 8850 35883 670357 428057 242300 858 9260 8013 64171 10325 70261 162888 79412 37600 100 0 37600 100 100 37500 0 0 0 0 0 0 1 ALLINA HEALTH SYSTEM DBA BUFFALO HOSPITAL 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 558396 SUPPORT GENERAL OPERATIONS BUFFALO HOSPITAL AND AED PROGRAM ALLINA HEALTH SYSTEM DBA CAMBRIDGE MEDICAL CENTER 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 85208 SUPPORT GENERAL OPERATIONS CAMBRIDGE MEDICAL CENTER ALLINA HEALTH SYSTEM DBA NEW ULM MEDICAL CENTER 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 351982 SUPPORT GENERAL OPERATIONS NEW ULM MEDICAL CENTER, COURAGE KENNY INSTITUTE RENOVATION AND LARYNGOSCOPY EQUIPMENT. ALLINA HEALTH SYSTEM DBA OWATONNA HOSPITAL 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 56669 SUPPORT GENERAL OPERATIONS OWATONNA HOSPITAL ALLINA HEALTH SYSTEM DBA RIVER FALLS AREA HOSPITAL 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 94692 SUPPORT GENERAL OPERATIONS RIVER FALLS AREA HOSPITAL AND PURCHASE OF LOCAL ART ALLINA HEALTH SYSTEM DBA ALLINA HOME CARE HOPSICE AND PALLIATIVE CARE 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 757127 INTEGRATIVE THERAPIES, OPERATIONS AND REIMBURSEMENT OF PATIENT BILLS ALLINA HEALTH SYSTEM DBA PENNY GEORGE INSTITUTE HEALTH & HEALING 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 357324 SUPPORT OF PGIHH OPERATIONS MINNEAPOLIS HEART INSTITUTE FOUNDATION 920 EAST 28TH STREET SUITE 100 MINNEAPOLIS MN 55407 411426406 501(C)(3) 50000 SUPPORT HEART OF NEW ULM FREE CLINIC OF PIERCE AND ST CROIX COUNTIES INC PO BOX 745 RIVER FALLS WI 54022 205892220 501(C)(3) 13469 SUPPORT GENERAL CLINIC OPERATIONS 10 0 HOUSING AND LIVING ASSISTANCE 169 61684 RESEARCH AND EDUCATION 28 36500 PART I, LINE 2: ALLINA ASSOCIATED FOUNDATION STRICTLY MONITORS GRANT FUNDS TO ENSURE THAT SUCH GRANTS ARE USED FOR PROPER AND INTENDED PURPOSES AND ARE NOT OTHERWISE DIVERTED FROM THE INTENDED USE. THE ORGANIZATION HAS A PROCESS THAT INCLUDES A WRITTEN APPLICATION REQUIRING SUPPORTING DOCUMENTATION AND SUBSTANTIATION PRIOR TO A GRANT BEING APPROVED AND DISBURSED. IN ADDITION AND DEPENDING ON THE FACTS AND CIRCUMSTANCE OF THE GRANT, THE ORGANIZATION EMPLOYS VARIOUS METHODS TO ENSURE PROPER AND INTENDED USE SUCH AS: PERIODIC REPORTING TO THE ORGANIZATION, FIELD INVESTIGATIONS, CONTRACTS WITH REPAYMENT CLAUSES, REQUIRING ADDITIONAL SUBSTANTIATION AND DOCUMENTATION NOT AVAILABLE AT THE TIME OF THE GRANT, PAYING THIRD PARTIES DIRECTLY ON BEHALF OF THE GRANTEE ORGANIZATION, AND OTHER METHODS AS APPROPRIATE AND WARRANTED. 1 1 0 0 0 0 1 0 1 1 DAVID ALBRECHT DIRECTOR 0 204959 0 46637 0 22943 0 42691 0 24609 0 341839 0 333 COURTNEY BAECHLER MD DIRECTOR 0 385482 0 73310 0 83640 0 72255 0 27259 0 641946 0 51594 JULIA CRIST DIRECTOR 0 147953 0 24115 0 18949 0 24559 0 26603 0 242179 0 0 TOBY FREIER DIRECTOR 0 270954 0 60357 0 28528 0 54796 0 31771 0 446406 0 4884 DAVID MILLER DIRECTOR 0 231103 0 51187 0 25391 0 52510 0 12477 0 372668 0 2599 JENNIFER MYSTER DIRECTOR 0 268000 0 55767 0 42236 0 49056 0 17664 0 432723 0 32351 GARY SHAW DIRECTOR 0 314468 0 67962 0 74558 0 56770 0 5949 0 519707 0 41859 STEPHEN BARITEAU DIRECTOR/PRESIDENT 0 237418 0 45595 0 25740 0 40797 0 25240 0 374790 0 21344 RICHARD MAGNUSON CFO 0 535410 0 86194 0 30212 0 154327 0 16259 0 822402 0 0 JAN MALCOLM FORMER DIRECTOR/FORMER PRESIDENT 0 10165 0 54312 0 312892 0 3257 0 1 0 380627 0 95242 DUNCAN GALLAGHER FORMER CFO 0 42110 0 369335 0 173372 0 22712 0 2450 0 609979 0 326501 PART I, LINES 4A-B LINE 4(A): JAN MALCOLM - $210,322 LINE 4(B): COURTNEY BAECHLER, MD - $46,135; STEPHEN BARITEAU - $22,300; JAN MALCOLM - $102,570; JENNIFER MYSTER - $30,889; GARY SHAW - $37,451; DUNCAN GALLAHER - $105,382 PART I, LINE 6 DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: MANAGEMENT INCENTIVE PLAN (MIP) ALLINA PROVIDES AN ANNUAL INCENTIVE COMPENSATION OPPORTUNITY TO MOST MANAGERS, SOME HIGH-LEVEL INDIVIDUAL CONTRIBUTORS AND EXECUTIVES. UNDER THIS PLAN, THE TARGET AWARD IS EXPRESSED AS A FUNCTION OF THE PARTICIPANT'S SALARY PAID DURING THE CALENDAR YEAR AND REQUIRES AT LEAST FOUR MONTHS OF SERVICE IN AN ELIGIBLE POSITION DURING THE YEAR. ACTUAL AWARDS CAN RANGE FROM 0% TO 150% OF THE TARGET AWARD, BASED ON ALLINA'S PERFORMANCE OVER THE CALENDAR YEAR. PERFORMANCE MEASURES INCLUDE FINANCIAL PERFORMANCE, HOSPITAL AND CLINIC CARE MEASURES AND HOSPITAL AND CLINIC PATIENT EXPERIENCE MEASURES. NO AWARDS ARE PROVIDED UNLESS THRESHOLD FINANCIAL PERFORMANCE IS ACHIEVED. PARTICIPANTS WHO HAVE LEFT EMPLOYMENT PRIOR TO THE END OF THE YEAR AS THE RESULT OF VOLUNTARY TERMINATION OR TERMINATION FOR POOR PERFORMANCE ARE NOT ELIGIBLE FOR AN AWARD. LONG-TERM INCENTIVE PLAN (LTIP) ALLINA HAS A LONG-TERM INCENTIVE PLAN THAT PROVIDES A CASH AWARD OPPORTUNITY TO A SMALL NUMBER OF TOP EXECUTIVES APPROVED FOR PARTICIPATION BY THE COMPENSATION COMMITTEE OF THE BOARD. THE AWARD OPPORTUNITY IS BASED ON ALLINA PERFORMANCE DURING OVERLAPPING THREE-YEAR CYCLES. PERFORMANCE MEASURES AND TARGETS ARE DEFINED BY THE COMMITTEE FOR EACH THREE-YEAR PERIOD AND CAN VARY FROM ONE PERIOD TO ANOTHER DEPENDING ON THE COMMITTEE'S JUDGMENT OF THE MOST IMPORTANT MEASURES OF SUCCESS. ACTUAL AWARDS CAN RANGE FROM 0% TO 150% OF TARGET AWARD, BASED ON ALLINA'S PERFORMANCE OVER THE PERFORMANCE PERIOD. PART I, LINE 8 CERTAIN AMOUNTS REPORTED ON FORM 990, PART VII WERE PAID OR ACCRUED PURSUANT TO A CONTRACT THAT WAS SUBJECT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGULATION SECTION 53.4958-4(A)(3). FROM TIME TO TIME, ALLINA HEALTH SYSTEM ENTERS INTO CONTRACTUAL ARRANGEMENTS THAT MAY QUALIFY FOR THE INITIAL CONTRACT EXCEPTION BASED ON THE TERMS AND UNDERSTANDINGS OF THE CONTRACTUAL AGREEMENTS. SCHEDULE J, LINE 4(A) & (B) ADDITIONAL COMPENSATION DISCLOSURE: DEFERRED COMPENSATION PLANS: TERMS AND CONDITIONS EXECUTIVE MUTUAL FUND ACCOUNT PLAN PHYSICIAN MUTUAL FUND ACCOUNT PLAN THESE ACCOUNTS GIVE THE PARTICIPANT THE OPPORTUNITY FOR CAPITAL ACCUMULATION NOT FULLY AVAILABLE TO THEM THROUGH SOCIAL SECURITY OR THE GENERAL EMPLOYEE RETIREMENT PLANS BECAUSE OF MAXIMUMS PLACED ON COMPENSATION THAT CAN BE RECOGNIZED UNDER FEDERAL LAW FOR PURPOSES OF CONTRIBUTIONS. THEY ALSO SERVE AS AN IMPORTANT NON-COMPETE INCENTIVE TO PARTICIPANTS. PRIOR TO THE YEAR IN WHICH CONTRIBUTIONS ARE MADE, THE PARTICIPANT MUST DESIGNATE A VESTING/PAYOUT DATE CONSISTENT WITH THE CONSTRAINTS OF THE PLANS AND FEDERAL DEFERRED COMPENSATION REGULATIONS. AFTER THE CONTRIBUTIONS ARE MADE, THE PARTICIPANT HAS A ONE-TIME LIMITED OPPORTUNITY TO EXTEND THE ELECTED PAYMENT DATE FOR AT LEAST FIVE YEARS. ONCE THE VESTING/PAYOUT DATE HAS BEEN REACHED, ALLINA WILL WITHHOLD THE APPROPRIATE TAXES AND THE BALANCE WILL BE PAID TO THE PARTICIPANT ON THEIR PAYCHECK AS SOON AS ADMINISTRATIVELY FEASIBLE. IF THE PARTICIPANT TERMINATES EMPLOYMENT VOLUNTARILY BEFORE AN AMOUNT IS PAID, PAYMENT WILL BE SUBJECT TO THE PARTICIPANT'S COMPLIANCE WITH A NON-COMPETE AGREEMENT WITH ALLINA FOR TWO YEARS AFTER TERMINATION. THE PARTICIPANT MAY ELECT FROM AMONG INVESTMENT ALTERNATIVES THAT ARE SIMILAR TO THOSE AVAILABLE IN THE RETIREMENT SAVINGS PLAN. UNLIKE THE RETIREMENT SAVINGS PLAN, THE PARTICIPANT HAS THE STATUS OF AN UNSECURED CREDITOR OF ALLINA AND WILL NOT HAVE A PREFERRED CLAIM TO PAYMENT IN THE CASE OF THE COMPANY'S INABILITY TO PAY. HOWEVER, THE COMPANY DOES SET ASIDE ASSETS FOR ITS OBLIGATIONS BY ACTUALLY INVESTING THE PROMISED ASSETS CONSISTENT WITH PARTICIPANT ELECTIONS. ALLINA SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) THIS PLAN WAS AMENDED EFFECTIVE DECEMBER 31, 2008, SUCH THAT NO FUTURE BENEFITS ACCRUE FOR SERVICE AFTER THAT DATE. ELIGIBLE ALLINA EXECUTIVES PARTICIPATED IN A DEFINED CONTRIBUTION SERP. EMPLOYER CREDITS WERE MADE EACH YEAR TO THEIR SERP BALANCE ACCORDING TO THE FOLLOWING SCHEDULE: EXEC YRS OF SERVICE CONTRIBUTION % OF PENSIONABLE EARNINGS 0-5 2.75% 6-10 3.50% 11+ 4.75% EXECUTIVES WERE ALSO CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE PENSION ACCOUNT PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE PENSION ACCOUNT PLAN CREDITING RATE AS DECLARED BY ALLINA. THE CURRENT RATE IS 4%. THE PARTICIPANT VESTS AFTER THREE YEARS OF EXECUTIVE SERVICE PROVIDED THAT IF THE PARTICIPANT TERMINATES EMPLOYMENT WITH ALLINA PRIOR TO AGE 65 FOR ANY REASON OTHER THAN ELIMINATION OF POSITION, THE PARTICIPANT MUST FULFILL THE TERMS OF A COVENANT NOT TO COMPETE. BENEFITS ARE PAID AS A SINGLE LUMP-SUM AMOUNT UPON AGE 65, RETIREMENT, OR JOB ELIMINATION. IN THE CASE OF OTHER VOLUNTARY TERMINATIONS, PAYMENT IS DELAYED UNTIL COMPLETION OF THE TWO-YEAR NON-COMPETE PERIOD. THE SERP IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. ALLINA EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN ELIGIBLE ALLINA EXECUTIVES PARTICIPATE IN A DEFERRED COMPENSATION RETIREMENT PLAN. EXECUTIVES ARE CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE ALLINA RETIREMENT SAVINGS PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. EMPLOYER CREDITS ARE MADE EACH YEAR TO THEIR ACCOUNT BALANCE ACCORDING TO THE FOLLOWING SCHEDULE AS OF THE END OF THE PLAN YEAR: PARTICIPANT'S YEARS OF VESTING SERVICE APPLICABLE PERCENTAGE LESS THAN 1 0% 1-5 5.0% 6-10 5.5% 11-15 6.0% 16 OR MORE 6.5% DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE INVESTMENT OPTIONS SELECTED BY THE PARTICIPANT WHICH ARE THE SAME OPTIONS AVAILABLE UNDER THE QUALIFIED PLAN. A PARTICIPANT WHO HAS COMPLETED AT LEAST TWO YEARS OF SERVICE BECOMES VESTED IN THE PORTION OF HIS OR HER ACCOUNT ATTRIBUTABLE TO THE ANNUAL CREDIT FOR A PARTICULAR YEAR AS OF JANUARY 15 OF THE YEAR FOLLOWING THE CALENDAR YEAR IN WHICH THE ANNUAL CREDIT IS EARNED. IN THE EVENT OF TERMINATION (OTHER THAN BECAUSE OF DEATH) PRIOR TO AGE 67, THE DISTRIBUTION DATE SHALL BE AS SOON AS ADMINISTRATIVELY POSSIBLE AFTER TERMINATION IN THE FORM OF A LUMP SUM PAYMENT. THE PLAN IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. THIS PLAN WAS EFFECTIVE JANUARY 1, 2009. EXECUTIVE SEVERANCE PLAN ALLINA PROVIDES SALARY CONTINUATION FOR EXECUTIVES WHOSE EMPLOYMENT HAS BEEN INVOLUNTARILY TERMINATED FOR REASONS OTHER THAN CAUSE OR POOR PERFORMANCE. THE LENGTH OF THE SEVERANCE PAY PERIOD IS DEFINED BY THE PLAN AND DEPENDS ON THE LEVEL OF THE EXECUTIVE POSITION. UNDER THE PLAN THE SEVERED EXECUTIVE ALSO COULD CONTINUE CERTAIN BENEFITS FOR A LIMITED PERIOD OF TIME. IN 2009 THE PLAN WAS AMENDED TO FURTHER RESTRICT SEVERANCE BENEFITS IN THE CASE THAT THE EXECUTIVE OBTAINS OTHER EMPLOYMENT DURING THE SEVERANCE PERIOD. SCHEDULE J, PART I, LINE 4 ALLINA HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER ORGANIZATION OF ALLINA ASSOCIATED FOUNDATION. ALLINA ASSOCIATED FOUNDATION IS THE SUPPORTING ORGANIZATION AND ALLINA HEALTH SYSTEM IS THE SUPPORTED ORGANIZATION. SEE SCHEDULE A AND SCHEDULE R FOR FURTHER DETAILS. ALLINA HEALTH SYSTEM PROVIDES ALLINA ASSOCIATED FOUNDATION WITH ADMINISTRATIVE AND STAFF SERVICES AT NO COST. THE VALUE OF THE SERVICES PROVIDED BY ALLINA HEALTH SYSTEM TO ALLINA ASSOCIATED FOUNDATION DURING 2017 WERE ESTIMATED AT $1,271,109 AND HAVE BEEN RECORDED AS CONTRIBUTION REVENUE FROM A RELATED ORGANIZATION IN THE STATEMENT OF REVENUE AND AS ADMINISTRATIVE AND FUNDRAISING EXPENSES IN THE STATEMENT OF FUNCTIONAL EXPENSES. ALLINA ASSOCIATED FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. COMPENSATION DISCLOSED AS PAID BY A RELATED ORGANIZATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATION. X 4 9086 FAIR MARKET VALUE X HOUSEHOLD GOODS 1 18138 FAIR MARKET VALUE 0 0 1 1 PART I, COLUMN (B): COLUMN (B) INCLUDES THE NUMBER OF CONTRIBUTORS. PART I, LINE 32B: ALLINA ASSOCIATED FOUNDATION MAY, FROM TIME TO TIME AND IN THE ORDINARY COURSE OF ITS CHARITABLE ACTIVITIES, ACCEPT NONCASH CONTRIBUTIONS OF PUBLICLY TRADED SECURITIES. ALLINA ASSOCIATED FOUNDATION USES THIRD PARTIES, SUCH AS SECURITIES BROKERAGE FIRMS, TO LIQUIDATE THE PUBLICLY TRADED SECURITIES TO CASH ON THE OPEN SECURITIES MARKET. THE SALE OF PUBLICLY TRADED SECURITIES ARE GENERALLY SUBJECT TO MARKET RATE BROKERAGE COMMISSIONS AND FEES OF THE THIRD PARTY SECURITIES BROKER. ALLINA ASSOCIATED FOUNDATION CASH AND INVESTMENTS ARE POOLED WITH ITS SOLE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM, AND ITS RELATED ORGANIZATIONS. FORM 990, ITEM J ALLINA ASSOCIATED FOUNDATION ITSELF DOES NOT HAVE A WEBSITE. EACH OF THE ORGANIZATIONS SUPPORTED BY ALLINA ASSOCIATED FOUNDATION HAVE A PHILANTHROPIC WEBSITE. THE FOLLOWING ARE THE WEBSITES: BUFFALO HOSPITAL-HTTPS://WWW.ALLINAHEALTH.ORG/BUFFALO-HOSPITAL/FOUNDATION/ CAMBRIDGE MEDICAL CENTER-HTTPS://WWW.ALLINAHEALTH.ORG/CAMBRIDGE-MEDICAL-CENTER/FOUNDATION NEW ULM MEDICAL CENTER-HTTPS://WWW.ALLINAHEALTH.ORG/NEW-ULM-MEDICAL-CENTER/FOUNDATION/ OWATONNA HOSPITAL-HTTPS://WWW.ALLINAHEALTH.ORG/OWATONNA-HOSPITAL/FOUNDATION/ RIVER FALLS AREA HOSPITAL-HTTPS://WWW.ALLINAHEALTH.ORG/RIVER-FALLS-AREA-HOSPITAL/FOUNDAT ION/ ALLINA HEALTH HOME CARE-HTTPS://WWW.ALLINAHEALTH.ORG/MEDICAL-SERVICES/CHRONIC-AND-ADVANCED -ILLNESS/HOSPICE/ALLINA-HEALTH-HOSPICE-FOUNDATION/ PENNY GEORGE INSTITUTE OF HEALTH & HEALING-HTTPS://WWW.ALLINAHEALTH.ORG/PENNY-GEORGE-INSTITUTE-FOR-HEALTH -AND-HEALING/PENNY-GEORGE-INSTITUTE-FOUNDATION/ FORM 990, PART V, LINE 1C: IN APRIL 2017, ALLINA ASSOCIATED FOUNDATION (DBA BUFFALO HOSPITAL FOUNDATION) HELD A FUNDRAISING EVENT THAT INCLUDED A RAFFLE. THE RAFFLE PRIZE EXCEEDED THE THRESHOLD FOR FORM W-2G REPORTING AND GAMBLING WITHHOLDING. THE PRIZE WAS INADVERTENTLY RELEASED TO THE RAFFLE WINNER PRIOR TO RECEIVING THE REQUIRED GAMBLING WITHHOLDING. ALLINA ASSOCIATED FOUNDATION MADE SEVERAL ATTEMPTS TO COLLECT THE NECESSARY WITHHOLDING FROM THE RAFFLE WINNER. ALL EFFORTS WERE UNSUCCESSFUL. ALLINA ASSOCIATED FOUNDATION ISSUED AND FILED FORM W-2G WITHOUT COLLECTING THE REQUIRED GAMBLING WITHHOLDING. FORM 990, PART VI, SECTION A, LINE 6 ALLINA HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER ORGANIZATION OF ALLINA ASSOCIATED FOUNDATION. ALLINA ASSOCIATED FOUNDATION IS THE SUPPORTING ORGANIZATION AND ALLINA HEALTH SYSTEM IS THE SUPPORTED ORGANIZATION. SEE SCHEDULE A AND SCHEDULE R FOR FURTHER DETAILS. ALLINA HEALTH SYSTEM PROVIDES ALLINA ASSOCIATED FOUNDATION WITH ADMINISTRATIVE AND STAFF SERVICES AT NO COST. THE VALUE OF THE SERVICES PROVIDED BY ALLINA HEALTH SYSTEM TO ALLINA ASSOCIATED FOUNDATION DURING 2017 WERE ESTIMATED AT $1,271,109 AND HAVE BEEN RECORDED AS CONTRIBUTION REVENUE FROM A RELATED ORGANIZATION IN THE STATEMENT OF REVENUE AND AS ADMINISTRATIVE AND FUNDRAISING EXPENSES IN THE STATEMENT OF FUNCTIONAL EXPENSES. ALLINA ASSOCIATED FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. COMPENSATION DISCLOSED AS PAID BY A RELATED ORGANIZATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE CORPORATE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM HOLDS CERTAIN RESERVED POWERS OVER ALLINA ASSOCIATED FOUNDATION. THE RESERVED POWERS ARE FULLY DESCRIBED IN ALLINA ASSOCIATED FOUNDATION'S GOVERNING DOCUMENTS AND INCLUDE SUCH POWERS AS ELECTION AND APPROVAL OF DIRECTORS, FINAL APPROVAL OF AMENDMENTS TO ARTICLES OF INCORPORATION OR BYLAWS, APPROVAL OF STRATEGIC PLANS AND CAPITAL AND OPERATING BUDGETS, APPROVAL OF PLANS OF MERGER OR CONSOLIDATION, APPROVAL OF INCURRENCE OF DEBT OR EXPENDITURES IN EXCESS OF CERTAIN AMOUNTS, AND VARIOUS OTHER RESERVED POWERS AS DESCRIBED THEREIN. FORM 990, PART VI, SECTION A, LINE 7B SEE THE EXPLANATION IN SCHEDULE O FOR FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION B, LINE 11B ALLINA ASSOCIATED FOUNDATION'S FORM 990 WAS PREPARED EXTERNALLY BY THE PUBLIC ACCOUNTING FIRM CLIFTON LARSON ALLEN. THE FORM 990 WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA HEALTH SYSTEM, ALLINA ASSOCIATED FOUNDATION'S SOLE CORPORATE MEMBER AND SUPPORTED ORGANIZATION'S TAX MANAGER AND TAX DIRECTOR. ALLINA'S VP OF FINANCE & SUPPLY CHAIN, AND ALLINA'S CHIEF FINANCIAL OFFICER ALSO PERFORMED AN EXECUTIVE REVIEW OF THE FORM 990. AFTER THE MANAGEMENT REVIEW PROCESS DESCRIBED ABOVE WAS COMPLETED, THE FINAL FORM 990, AS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE ["IRS"], WAS PROVIDED TO EACH VOTING MEMBER OF ALLINA ASSOCIATED FOUNDATION'S BOARD OF DIRECTORS. ALLINA ASSOCIATED FOUNDATION'S BOARD OF DIRECTORS VOTED ON AND APPROVED A RESOLUTION APPROVING THE FORM 990, THE MINNESOTA CHARITABLE ORGANIZATION ANNUAL REPORT TO BE FILED WITH THE MINNESOTA ATTORNEY GENERAL, AND THE WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT TO BE FILED WITH THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTIONS. THE BOARD OF DIRECTORS RESOLUTION ALSO DIRECTED OFFICERS TO FILE THE FORM 990 WITH THE IRS, THE CHARITABLE ANNUAL REPORT WITH THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL, AND THE WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTIONS. THE ABOVE STATED REVIEW AND APPROVAL PROCESS OCCURRED PRIOR TO FILING ALLINA ASSOCIATED FOUNDATION'S FORM 990 WITH THE IRS, MINNESOTA CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE MINNESOTA ATTORNEY GENERAL, AND WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE WISCONSIN DEPARTMENT FINANCIAL INSTITUTIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS SEVERAL METHODS OF MONITORING AND ENFORCING COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. FIRST, THE ORGANIZATION REGULARLY DISTRIBUTES CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRES TO ITS OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES. THESE INDIVIDUALS ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS, INCLUDING ANY FAMILY OR BUSINESS RELATIONSHIP. SECOND, THE GENERAL COUNSEL'S OFFICE ANNUALLY DELIVERS A REPORT TO ALLINA'S BOARD OF DIRECTORS WHICH INCLUDES, AMONG OTHER THINGS, THE RESULTS OF THE CONFLICT OF INTEREST QUESTIONNAIRE, AN ANALYSIS OF POTENTIAL CONFLICTS, AND GUIDANCE FOR SATISFACTORILY RESOLVING CONFLICTS. THIRD, THE ORGANIZATION UNDERTAKES MANDATORY COMPLIANCE TRAINING OF ALL ITS EMPLOYEES WHICH INCLUDES TRAINING ON CONFLICTS OF INTEREST. FOURTH, ALL EMPLOYEES RECEIVE, AND ARE EXPECTED TO CONDUCT THEMSELVES IN ACCORDANCE WITH ALLINA'S CODE OF CONDUCT. THE CODE OF CONDUCT CONTAINS EDUCATIONAL MATERIALS AND GUIDANCE TO RESOLVE POTENTIAL CONFLICTS OF INTEREST. FIFTH, ALLINA MAINTAINS A CORPORATE INTEGRITY HOTLINE, A CONFIDENTIAL 24 HOUR EXTERNAL RESOURCE TO HELP ANSWER QUESTIONS RELATED TO ETHICAL BUSINESS CONDUCT. ALL CALLS TO THE INTEGRITY LINE ARE KEPT CONFIDENTIAL. FORM 990, PART VI, SECTION B, LINE 15 ALLINA ASSOCIATED FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ANY COMPENSATION DISCLOSED AS PAID BY A RELATED ORGANIZATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATION. THEREFORE, PART VI, SECTION B, LINE 15A AND LINE 15B ARE NOT APPLICABLE TO ALLINA ASSOCIATED FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 ALLINA ASSOCIATED FOUNDATION MAKES ITS FORM 990, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. TO ARRANGE AN INSPECTION OR RECEIVE A COPY, PLEASE CONTACT THE FOLLOWING: ALLINA ASSOCIATED FOUNDATION TAX SERVICES MAIL ROUTE 10890 P.O. BOX 43 MINNEAPOLIS, MN 55407-0043 TELEPHONE: 612-262-0660 PHYSICAL ADDRESS: 2925 CHICAGO AVENUE MINNEAPOLIS, MN 55407-1321 THE FORM 990 AND FORM 1023 ARE ALSO AVAILABLE DIRECTLY FROM THE INTERNAL REVENUE SERVICE. THE FORM 990 AND FINANCIAL STATEMENTS ARE ALSO AVAILABLE FROM THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -11,926. FORM 990, PART XII, LINE 2C: THIS PROCESS REMAINS UNCHANGED FROM THE PRIOR YEAR. ABBOTT NORTHWESTERN HOSPITAL FOUNDATION PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 043643816 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I ALLINA HEALTH SYSTEM 0 MERCY & UNITY HOSPITALS FOUNDATION PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 300086426 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I ALLINA HEALTH SYSTEM 0 PHILLIPS EYE INSTITUTE FOUNDATION PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 411613017 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I ALLINA HEALTH SYSTEM 0 COURAGE KENNY FOUNDATION PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 411952989 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I ALLINA HEALTH SYSTEM 0 UNITED HOSPITAL FOUNDATION PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 237420998 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I ALLINA HEALTH SYSTEM 0 ALLINA HEALTH SYSTEM PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 363261413 HEALTHCARE SERVICES MN 501(C)(3) LINE 3 0 MBP FACILITY LLC PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 454078371 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I N/A 0 REGINA FOUNDATION PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 411987372 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I N/A 0 APPLE VALLEY BUILDING ASSOCIATES LLC 14655 GALAXIE AVENUE S APPLE VALLEY MN 55124 411677072 RENTAL REAL ESTATE MN N/A METROPOLITAN INTEGRATED CANCER CENTER LLC PO BOX 819067 DALLAS TX 75381 205068485 RADIOLOGY DE N/A MAGNETO LEASING LLC PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 201582501 RENTAL EQUIPMENT MN N/A ASPEN SLEEP CENTERLLC 1010 BANDANA BOULEVARD WEST ST PAUL MN 55108 261850227 HEALTHCARE SERVICES MN N/A GERIATRIC SERVICES OF MINNESOTA LLC 3433 BROADWAY ST NE SUITE 300 MINNEAPOLIS MN 55413 453357936 HEALTHCARE SERVICES MN N/A NORTHSTAR SLEEP CENTER LLC 920 EAST 28TH STREET SUITE 700 MINNEAPOLIS MN 55407 452532456 HEALTHCARE SERVICES MN N/A MOBILE IMAGING SERVICES LLC 7505 METRO BOULEVARD SUITE 400 EDINA MN 55439 411883212 RADIOLOGY MN N/A CROSBY CARDIOVASCULAR SERVICESLLC 920 E 28TH STREET SUITE 500 MINNEAPOLIS MN 55407 412010368 HEALTHCARE SERVICES MN N/A BPA HEALTH LLC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 352490984 HEALTHCARE SERVICES MN N/A TWIN CITIES MEDICAL IMAGING LLC 7505 METRO BOULEVARD SUITE 400 EDINA MN 55439 463959737 RADIOLOGY MN N/A WESTHEALTH SURGERY CENTER LLC PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 371763155 SURGICAL SERVICES MN N/A CT ONE LLC 200 STATE AVENUE FARIBAULT MN 55021 261187480 RADIOLOGY MN N/A HEALTHCARE CAMPUS IMAGING ONE LLC 200 STATE AVENUE FARIBAULT MN 55021 522401657 RADIOLOGY MN N/A HEALTHSPAN SERVICES COMPANY PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 55440 411249999 DEBT COLLECTION MN N/A C 0 ALLINA SPECIALTY ASSOCIATES INC PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 55440 411802815 HEALTHCARE SERVICES MN N/A C 0 ALLINA HEALTH SYSTEM TRUST PO BOX 535007 PITTSBURGH PA 15253 276712988 TRUST PA N/A T 0 ALLINA HEALTH SYSTEM DEFINED BENEFIT MASTER TRUST 500 GRANT STREET SUITE 0625 PITTSBURGH PA 15258 376520273 TRUST PA N/A T 0 LIFESPAN AFFILIATES DEFERRED COMPENSATION PLAN PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 55440 411720860 TRUST MN N/A T 0 ALLINA INTEGRATED MEDICAL NETWORK PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 55440 275129095 HEALTHCARE SERVICES MN N/A C 0 FORSETI RISK MANAGEMENT INDEMNIFICATION COMPANY SPC PO BOX 1085 GRAND CAYMAN CJ 981366132 CAPTIVE INSURANCE CJ N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1