NAEVE HEALTH CARE FOUNDATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: NAEVE HEALTH CARE FOUNDATION (EIN 41-1989509)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-20
IRS object ID: 201713249349300106
Schema version: 2016v3.0
Note: A later return for the same period supersedes this one.
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 D
Schedule F
Schedule I
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-20T08:39:19-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	411437424	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	HILL BENDA SKOV AND BERNAU PA	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1655 W MAIN ST SKYLINE PLAZA	AddressLine1Txt
City	ALBERT LEA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	560072657	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	411989509	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SUE LOCH	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	5073776380	PhoneNum
Signature	2017-11-15	SignatureDt

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	HEATHER BENDA	PreparerPersonNm
PTIN	P01285282	PTIN
Phone	5073771333	PhoneNum
Preparation	2017-11-20	PreparationDt

Filing Security Information FilingSecurityInformation

Field	Value	IRS element (for citing)
At Submission Creation Device Id	AE5F1AB9A4A492DBFA408EA34423F417E60B8386	AtSubmissionCreationDeviceId
At Submission Filing Device Id	AE5F1AB9A4A492DBFA408EA34423F417E60B8386	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2018-03-14 21:41:22Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Amended Return	Yes (X)	AmendedReturnInd
Principal Officer	SUE LOCH	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1950 LAKEWOOD AVE	AddressLine1Txt
City	ALBERT LEA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56007	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$2,354,327	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTP:WWW.NAEVEFOUNDATION.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2000	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	RAISING PHILANTHROPIC DOLLARS FOR HIGH QUALITY COST EFFECTIVE HEALTHCARE AT MCHS IN ALBERT LEA	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	11	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$39,137	PYContributionsGrantsAmt
CY Contributions Grants	$9,403	CYContributionsGrantsAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$96,918	PYInvestmentIncomeAmt
CY Investment Income	$215,880	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$136,055	PYTotalRevenueAmt
CY Total Revenue	$225,283	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$219,617	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	$36,277	PYOtherExpensesAmt
CY Other Expenses	$40,490	CYOtherExpensesAmt
PY Total Expenses	$37,277	PYTotalExpensesAmt
CY Total Expenses	$260,107	CYTotalExpensesAmt
PY Revenues Less Expenses	$98,778	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$34,824	CYRevenuesLessExpensesAmt
Total Assets BOY	$4,706,302	TotalAssetsBOYAmt
Total Assets EOY	$4,802,328	TotalAssetsEOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$4,706,302	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$4,802,328	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO ENSURE THE FUTURE OF LOCAL, QUALITY HEALTH CARE THROUGH THE CONTINUED DEVELOPMENT OF A PERMANENT ENDOWMENT FUND AND OTHER PHILANTHROPIC RELATIONSHIPS AND ACTIVITIES AS MAY BE DEEMED APPROPRIATE FOR THE GROWTH AND DEVELOPMENT OF MHCS IN ALBERT LEA AND SURROUNDING COMMUNITIES.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$219,617	ExpenseAmt
Grant	$219,617	GrantAmt
Desc	NAEVE HEALTH CARE FOUNDATION'S GIFT WAS DIRECTED TOWARDS PROJECTS WITHIN MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$355	ExpenseAmt
Desc	CARDIAC REHAB DONATION - PROGRAM WITHDRAWAL	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$355	TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses	$219,972	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	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	false	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	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	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	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	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	false	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	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	false	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	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	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	MARY A WOLESKY	PersonNm
Phone	5074341595	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 1ST DRIVE NW	AddressLine1Txt
City	AUSTIN	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55912	ZIPCd

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

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
STEPHEN BROWNLOW
DIRECTOR	Yes (X)	$0	$0	$0
ALEX JOHNSTON
VICE PRESIDE	Yes (X)	$0	$0	$0	Yes (X)
RICHARD MUELLER
DIRECTOR	Yes (X)	$0	$0	$0
DIANE CLARK
SECRETARY	Yes (X)	$0	$0	$0	Yes (X)
SUE LOCH
PRESIDENT	Yes (X)	$0	$0	$0	Yes (X)
RICH MURRAY
TREASURER	Yes (X)	$0	$0	$0	Yes (X)
CLIFFORD RASK
DIRECTOR	Yes (X)	$0	$0	$0
DAN KOLKER
DIRECTOR	Yes (X)	$0	$0	$0
DR TED MYERS
PAST PRESIDE	Yes (X)	$0	$0	$0	Yes (X)
DIANE DAMEROW
DIRECTOR	Yes (X)	$0	$0	$0
KARI ULRICH
DIRECTOR	Yes (X)	$0	$0	$0
DR MARK CIOTA
EX OFFICIO O		$0	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	false	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
All Other Contributions	$9,403	AllOtherContributionsAmt
Total Contributions	$9,403	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$134,203	TotalRevenueColumnAmt
Exclusion	$134,203	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,210,721	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$2,129,044	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$81,677	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$81,677	TotalRevenueColumnAmt
Exclusion	$81,677	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$225,283	TotalRevenueColumnAmt
Exclusion	$215,880	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$219,617	TotalAmt
Program Services	$219,617	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$34,337	TotalAmt
Management And General	$34,337	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$6,153	TotalAmt
Program Services	$355	ProgramServicesAmt
Management And General	$5,798	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$260,107	TotalAmt
Program Services	$219,972	ProgramServicesAmt
Management And General	$40,135	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$6,745	BOYAmt
EOY	$5,798	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$4,689,205	BOYAmt
EOY	$4,786,505	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$10,352	BOYAmt
EOY	$10,025	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,706,302	BOYAmt
EOY	$4,802,328	EOYAmt

Total Liabilities TotalLiabilitiesGrp

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

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,311,939	BOYAmt
EOY	$4,380,271	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$112,820	BOYAmt
EOY	$140,514	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$281,543	BOYAmt
EOY	$281,543	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,706,302	BOYAmt
EOY	$4,802,328	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,706,302	BOYAmt
EOY	$4,802,328	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$34,824	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$130,850	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CLINIC HEALTH SYSTEMS-ALBERT LEA & AUSTIN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
EIN	411506440	EIN
Organization Type	3	OrganizationTypeCd
Governing Document Listed	Yes (true)	GoverningDocumentListedInd
Support	$219,617	SupportAmt
Other Support	$0	OtherSupportAmt

Field	Value	IRS element (for citing)
Supported Organizations Total	1	SupportedOrganizationsTotalCnt
Support Sum	$219,617	SupportSumAmt
Other Support Sum	$0	OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

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

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

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

Adjusted Net Income AdjustedNetIncomeGrp

Net ST Capital Gain Adj Net Incm NetSTCapitalGainAdjNetIncmGrp

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

Recoveries PY Distributions RecoveriesPYDistributionsGrp

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

Other Gross Income OtherGrossIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$158,967	PriorYearAmt
Current Year	$134,203	CurrentYearAmt

Adjusted Gross Income AdjustedGrossIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$158,967	PriorYearAmt
Current Year	$134,203	CurrentYearAmt

Depreciation Depletion DepreciationDepletionGrp

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

Production Income ProductionIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$36,277	PriorYearAmt
Current Year	$34,337	CurrentYearAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Prior Year	$1,000	PriorYearAmt
Current Year	$6,153	CurrentYearAmt

Total Adjusted Net Income TotalAdjustedNetIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$121,690	PriorYearAmt
Current Year	$93,713	CurrentYearAmt

Minimum Asset Amount MinimumAssetAmountGrp

Average Monthly FMV Of Sec AverageMonthlyFMVOfSecGrp

Field	Value	IRS element (for citing)
Prior Year	$4,706,302	PriorYearAmt
Current Year	$4,802,328	CurrentYearAmt

Average Monthly Cash Balances AverageMonthlyCashBalancesGrp

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

FMV Other Non Exempt Use Asset FMVOtherNonExemptUseAssetGrp

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

Total FMV Of Non Exempt Use Asset TotalFMVOfNonExemptUseAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$4,706,302	PriorYearAmt
Current Year	$4,802,328	CurrentYearAmt

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

Acquisition Indebtedness AcquisitionIndebtednessGrp

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

Adjusted FMV Less Indebtedness AdjustedFMVLessIndebtednessGrp

Field	Value	IRS element (for citing)
Prior Year	$4,706,302	PriorYearAmt
Current Year	$4,802,328	CurrentYearAmt

Cash Deemed Charitable CashDeemedCharitableGrp

Field	Value	IRS element (for citing)
Prior Year	$70,595	PriorYearAmt
Current Year	$72,035	CurrentYearAmt

Net Vl Non Exempt Use Assets NetVlNonExemptUseAssetsGrp

Field	Value	IRS element (for citing)
Prior Year	$4,635,707	PriorYearAmt
Current Year	$4,730,293	CurrentYearAmt

Pct Of Net Vl Non Exempt Use Ast PctOfNetVlNonExemptUseAstGrp

Field	Value	IRS element (for citing)
Prior Year	$162,250	PriorYearAmt
Current Year	$165,560	CurrentYearAmt

Recoveries PY Distri Min Asset RecoveriesPYDistriMinAssetGrp

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

Total Minimum Asset TotalMinimumAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$162,250	PriorYearAmt
Current Year	$165,560	CurrentYearAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
CY Adj Net Income Distributable	$121,690	CYAdjNetIncomeDistributableAmt
CY Pct85 Adjusted Net Income	$103,437	CYPct85AdjustedNetIncomeAmt
CY Total Min Ast Distributable	$162,250	CYTotalMinAstDistributableAmt
CY Greater Adjusted Minimum	$162,250	CYGreaterAdjustedMinimumAmt
CY Income Tax Imposed PY	$0	CYIncomeTaxImposedPYAmt
CY Distributable As Adjusted	$162,250	CYDistributableAsAdjustedAmt
First Year Type3 Non Func	Yes (X)	FirstYearType3NonFuncInd

Distributions DistributionsGrp

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

Distribution Allocations DistributionAllocationsGrp

Field	Value	IRS element (for citing)
CY Distributable As Adjusted	$162,250	CYDistributableAsAdjustedAmt
Underdistributions	$0	UnderdistributionsAmt
Excess Distribution Cyov Yr3	$0	ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2	$0	ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1	$0	ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov	$0	TotalExcessDistributionCyovAmt
Cyov Applied Underdistri PY	$0	CyovAppliedUnderdistriPYAmt
Cyov Applied Underdistr CPY	$0	CyovAppliedUnderdistrCPYAmt
Excess Distribution Cyov	$0	ExcessDistributionCyovAmt
CY Total Annual Distributions	$0	CYTotalAnnualDistributionsAmt
CY Distrib App Underdistri PY	$0	CYDistribAppUnderdistriPYAmt
Excess Distribution	$0	ExcessDistributionAmt
Remaining Underdistri PY	$0	RemainingUnderdistriPYAmt
Remaining Underdistri CY	$162,250	RemainingUnderdistriCYAmt
Excess Distri Cyov To Next Yr	$0	ExcessDistriCyovToNextYrAmt
Excess From Year4	$0	ExcessFromYear4Amt
Excess From Year3	$0	ExcessFromYear3Amt
Excess From Year2	$0	ExcessFromYear2Amt
Excess From Year1	$0	ExcessFromYear1Amt

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

Field	Value	IRS element (for citing)
Form And Line Reference	PART IV, SECTION D, LINE 3	FormAndLineReferenceDesc
Explanation	THE CEO OF THE FOUNDATION'S SUPPORTED ORGANIZATION, MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN (THE "MEDICAL CENTER"), SERVES AS AN EX OFFICIO VOTING MEMBER OF THE BOARD OF TRUSTEES OF THE FOUNDATION. THE MEDICAL CENTER'S CEO ALSO SERVES AS AN EX OFFICIO MEMBER OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER, THUS PROVIDING REPRESENTATION OF MEDICAL CENTER LEADERSHIP ON THE BOARD OF THE FOUNDATION AT BOTH THE OFFICER AND GOVERNING BODY LEVELS OF THE MEDICAL CENTER. THE MEDICAL CENTER CEO IS COMMITTED TO ENSURING THAT THE FOUNDATION'S FACILITIES ARE MANAGED AND OPERATED IN A MANNER THAT REFLECTS THE MEDICAL CENTER'S CHARITABLE PURPOSES AND MISSION. HE IS ACTIVELY ENGAGED AS A BOARD MEMBER IN THE FOUNDATION'S GOVERNANCE AND PARTICIPATES IN DECISIONS AND DISCUSSIONS AT THE BOARD LEVEL AND WITH THE FOUNDATION'S LEADERSHIP IN ALL ASPECTS OF THE FOUNDATION'S MANAGEMENT AND USE OF ITS INCOME AND ASSETS FOR THE BENEFIT OF THE MEDICAL CENTER. IN ADDITION, THE FOUNDATION'S BYLAWS PROVIDES THAT THE FOUNDATION MUST MAINTAIN A CLOSE AND CONTINUOUS WORKING RELATIONSHIP WITH THE MEDICAL CENTER'S OFFICERS AND DIRECTORS IN ORDER TO ENSURE THAT THE MEDICAL CENTER'S LEADERSHIP HAS A SIGNIFICANT VOICE IN THE FOUNDATION'S OPERATIONS AND ITS ACQUISITION, USE, AND MANAGEMENT OF ITS INCOME AND ASSETS.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$301,543	BeginningYearBalanceAmt
Grants Or Scholarships	$20,000	GrantsOrScholarshipsAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	WELLS FARGO INVESTMENTS	Desc
Book Value	$4,786,505	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$4,786,505	TotalBookValueSecuritiesAmt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	false	GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (6 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
CENTRAL AMERICA, CARIBBEAN,	INVESTMENTS	$269,162
EAST ASIA, PACIFIC,	INVESTMENTS	$174,703
EUROPE (INCLUDING ICELAND AND GREENLAND)	INVESTMENTS	$146,226
MIDDLE EAST, NORTH AFRICA	INVESTMENTS	$114,753
RUSSIA AND NEWLY INDEPENDENT STATES	INVESTMENTS	$92,293
NORTH AMERICA-CANADA AND MEXICO-NOT US	INVESTMENTS	$116,449

Field	Value	IRS element (for citing)
Subtotal Spent	$913,586	SubtotalSpentAmt
Total Spent	$913,586	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	false	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE F, PAGE 1, PART I, LINE 3	FormAndLineReferenceDesc
Explanation	CENTRAL AMERICA, CARIBBEAN, 0 269,162 EAST ASIA, PACIFIC, 0 174,703 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 146,226 MIDDLE EAST, NORTH AFRICA 0 114,753 RUSSIA AND NEWLY INDEPENDENT STATES 0 92,293 NORTH AMERICA-CANADA AND MEXICO-NOT US 0 116,449	ExplanationTxt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	false	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CLINIC HEALTH SYSTEM-AL	BusinessNameLine1Txt

US Address USAddress

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

Field	Value	IRS element (for citing)
Recipient EIN	411404075	RecipientEIN
IRC Section	501 C3	IRCSectionDesc
Cash Grant	$219,617	CashGrantAmt
Purpose Of Grant	SUPPORT PROGRAMS	PurposeOfGrantTxt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	GRANTS ARE USED TO SUPPORT THE OPERATIONS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. GRANTS CAN ONLY BE USED FOR THE INTENDED PURPOSE. NO ADDITIONAL MONITORING IS PERFORMED.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 1, ITEM B	SCHEDULE A HAD THE ENTITY LISTED AS TYPE II UNDER QUESTION 12. THE ENTITY IS A TYPE III NON-FUNCTIONALLY INTEGRATED ORGANIZATION SO CORRECTED ON THIS AMENDED TAX RETURN.
FORM 990 - ORGANIZATION'S MISSION	TO ENSURE THE FUTURE OF LOCAL, QUALITY HEALTH CARE THROUGH THE CONTINUED DEVELOPMENT OF A PERMANENT ENDOWMENT FUND AND OTHER PHILANTHROPIC RELATIONSHIPS AND ACTIVITIES AS MAY BE DEEMED APPROPRIATE FOR THE GROWTH AND DEVELOPMENT OF MHCS IN ALBERT LEA AND SURROUNDING COMMUNITIES.
FORM 990, PAGE 2, PART III, LINE 4D	CARDIAC REHAB DONATION - PROGRAM WITHDRAWAL
FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 IS PREPARED BY A LOCAL CPA OFFICE AND THEN REVIEWED BY THE BOARD MEMBERS OF THE ORGANIZATION
FORM 990, PAGE 6, PART VI, LINE 12C	IN ACCORDANCE WITH THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, THE FOLLOWING INDIVIDUALS ARE REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST ACKNOWLEDGEMENT: BOARD OF TRUSTEE MEMBERS MEMBERS OF THE MAJOR NAEVE HEALTH CARE FOUNDATION COMMITTEES ANY INDIVIDUAL FROM THE ABOVE GROUPS MAY BE ASKED TO ABSTAIN FROM VOTING OR PARTICIPATING IN THE DECISION MAKING ACTIVITES AFFECTED BY THE CONFLICT OF INTEREST DISCLOSURE. AN INDIVIDUAL MAY BE AKSED TO LEAVE A MEETING WHERE THE DECISION MAKING ACTIVITIES WOULD BE AFFECTED BY THE CONFLICT OF INTERST DISCLOSURE. IF AN INDIVIDUAL NEGLECTS TO DISCLOSE APPROPRIATELY, DISCIPLINARY ACTION WILL BE CONSIDERED UP TO AND INCLUDING TERMINATION OF EMPLOYMENT AND/OR POSITION ON THE FOUNDATION BOARD. THE COMPLIANCE OFFICER OF MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN ASSISTS THE BOARD IN DISTRIBUTION AND COLLECTION OF ANNUAL CONFLICT OF INTEREST DISCLOSURE FORMS.
FORM 990, PAGE 6, PART VI, LINE 19	NO DOCUMENTS AVAILABLE TO THE PUBLIC