RIDGEVIEW FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- RIDGEVIEW FOUNDATION (EIN 41-1328097)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201703199349314320
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T15:41:41-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | 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 | 411328097 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIDGEVIEW FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RIDG | BusinessNameControlTxt |
| Phone | 9524426010 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 SOUTH MAPLE STREET | AddressLine1Txt |
| City | WACONIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55387 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORDON GABLENZ | PersonNm |
| Person Title | CFO & CIO | PersonTitleTxt |
| Phone | 9524426010 | PhoneNum |
| Signature | 2017-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT E SCHILE | PreparerPersonNm |
| Phone | 6123764500 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-14 | IPDt |
| IP Tm | 14:47:00 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 977139128611A4E36F514149905081B6C9A4065F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 1FBCD4AA4D8DA69ACB92FF11632DDFE988DCF009 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT STEVENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 SOUTH MAPLE STREET | AddressLine1Txt |
| City | WACONIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55387 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,863,645 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RIDGEVIEWMEDICAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO MAKE A POSITIVE DIFFERENCE IN THE QUALITY OF LIFE AND HEALTH FOR THE PEOPLE OF OUR AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 23 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 446 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,017,312 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,308,132 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $313,332 | PYInvestmentIncomeAmt |
| CY Investment Income | $284,914 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$214,237 | PYOtherRevenueAmt |
| CY Other Revenue | -$308,851 | CYOtherRevenueAmt |
| PY Total Revenue | $4,116,407 | PYTotalRevenueAmt |
| CY Total Revenue | $2,284,195 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,504,417 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,524,664 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $74,861 | PYOtherExpensesAmt |
| CY Other Expenses | $593,585 | CYOtherExpensesAmt |
| PY Total Expenses | $2,579,278 | PYTotalExpensesAmt |
| CY Total Expenses | $2,118,249 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,537,129 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $165,946 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,558,175 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,906,384 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $972,894 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $895,797 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,585,281 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,010,587 | NetAssetsOrFundBalancesEOYAmt |
| Mission | RIDGEVIEW FOUNDATION IS AN INDEPENDENT NONPROFIT ORGANIZATION THAT PARTNERS WITH RIDGEVIEW MEDICAL CENTER IN ITS MISSION TO MAKE A POSITIVE DIFFERENCE IN THE QUALITY OF LIFE AND HEALTH FOR THE PEOPLE OF OUR AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,058,245 | ExpenseAmt |
| Grant | $1,524,664 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | TO RAISE FUNDS EXCLUSIVELY FOR THE BENEFIT OF RIDGEVIEW MEDICAL CENTER,A NOT-FOR-PROFIT HOSPITAL IN WACONIA, MINNESOTA. DURING THE YEAR ENDEDDECEMBER 31, 2016, RIDGEVIEW FOUNDATION EXPENSED A TOTAL OF $944,552TO RIDGEVIEW MEDICAL CENTER. OF THIS, $223,089 WAS TRANSFERRED TO THE HOSPITAL TO SUPPORT THE BUILDING AND FURNISHING OF A HEART CENTER AND CATH LAB AT THE HOSPITAL, $157,530 WAS TRANSFERRED TO THE HOSPITAL FOR THE COMMUNICATIONS CENTER, AND $118,594 WAS TRANSFERRED TO THE HOSPITAL FOR THE RENOVATION OF THE MEDICAL/SURGICAL WING AND TO AID IN THE EXPANSION OF CRITICAL SERIVCES. THE REMAINING $445,339 TRANSFERRED TO THE HOSPITAL WAS USED FOR VARIOUS PROJECTS AND PROGRAMS DURING 2016. | Desc |
| Total Program Service Expenses | $2,058,245 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 23 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 23 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GORDON GABLENZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9524422191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 SOUTH MAPLE STREET | AddressLine1Txt |
| City | WACONIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55387 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|
| CHUCK SPEVACEK | |||||||
| CHAIRPERSON | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| FRED GREEN | |||||||
| VICE CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DERMOT COWLEY | |||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DARLA HOLMGREN | |||||||
| TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NANCY BACH | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| KATHRYN BARNES | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN BENIEK | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JEAN BULLER | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JON CROW | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| STACY DESAI | |||||||
| BOARD MEMBER (THROUGH 2016) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| MIKE DRAZAN | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| TIM FOSTER | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JOHN HAYES | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| GREG KUMMER | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JIM LEONARD | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| RICK POLK | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| LINDA ROEBKE | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DR DANIEL ROSS DDS | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DR LORENE RUTHERFORD MD | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| MARK STEINGAS | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| CARLA STRUBLE | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| PAUL WHITTAKER | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JEFF WIGEN | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DAVID WINDSCHITL | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| STEVE YOUNGSTEDT | |||||||
| BOARD MEMBER (THROUGH 2016) | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT STEVENS | |||||||
| PRESIDENT / CEO | 0.50 | Yes (X) | $0 | $433,264 | $23,091 | 49.50 | |
| GORDON GABLENZ | |||||||
| CFO & CIO | 0.50 | Yes (X) | $0 | $620,943 | $25,289 | 49.50 | |
| DOUGLAS STASEK | |||||||
| EXECUTIVE DIRECTOR | 47.50 | Yes (X) | $0 | $215,645 | $32,406 | 2.50 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,269,852 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $80,786 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $650,897 | FundraisingAmt |
| All Other Contributions | $1,657,235 | AllOtherContributionsAmt |
| Noncash Contributions | $407,383 | NoncashContributionsAmt |
| Total Contributions | $2,308,132 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127,973 | TotalRevenueColumnAmt |
| Exclusion | $127,973 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,359,642 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,202,701 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $156,941 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $156,941 | TotalRevenueColumnAmt |
| Exclusion | $156,941 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $55,948 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $650,897 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $363,044 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$307,096 | TotalRevenueColumnAmt |
| Exclusion | -$307,096 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $11,950 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $13,705 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,755 | TotalRevenueColumnAmt |
| Exclusion | -$1,755 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,284,195 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$23,937 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,507,664 | TotalAmt |
| Program Services | $1,507,664 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,000 | TotalAmt |
| Program Services | $17,000 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,391 | TotalAmt |
| Management And General | $9,391 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,971 | TotalAmt |
| Management And General | $68,971 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,039 | TotalAmt |
| Management And General | $6,039 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$24,497 | TotalAmt |
| Management And General | -$24,497 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS EXPENSES | Desc |
| Total | $533,681 | TotalAmt |
| Program Services | $533,581 | ProgramServicesAmt |
| Management And General | $100 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,118,249 | TotalAmt |
| Program Services | $2,058,245 | ProgramServicesAmt |
| Management And General | $60,004 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,082,897 | BOYAmt |
| EOY | $843,633 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,119,349 | BOYAmt |
| EOY | $1,197,732 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,687,738 | BOYAmt |
| EOY | $1,404,800 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $76,600 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,697 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,697 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,743,202 | BOYAmt |
| EOY | $6,239,192 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,824,989 | BOYAmt |
| EOY | $5,144,427 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,558,175 | BOYAmt |
| EOY | $14,906,384 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $872,894 | BOYAmt |
| EOY | $820,797 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $75,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,894 | BOYAmt |
| EOY | $895,797 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,447,251 | BOYAmt |
| EOY | $8,392,906 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,359,344 | BOYAmt |
| EOY | $2,611,028 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,778,686 | BOYAmt |
| EOY | $3,006,653 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,585,281 | BOYAmt |
| EOY | $14,010,587 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,558,175 | BOYAmt |
| EOY | $14,906,384 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $165,946 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $259,360 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,208,259 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,409,325 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,665,055 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,017,312 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,308,131 | CurrentTaxYearAmt |
| Total | $13,608,082 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,208,259 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,409,325 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,665,055 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,017,312 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,308,131 | CurrentTaxYearAmt |
| Total | $13,608,082 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $13,608,082 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $65,816 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $71,712 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $95,293 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $106,017 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $127,973 | CurrentTaxYearAmt |
| Total | $466,811 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $298,980 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $425,042 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $122,117 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $106,718 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $67,898 | CurrentTaxYearAmt |
| Total | $1,020,755 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,095,648 | TotalSupportAmt |
| Public Support CY170 | 0.90150 | PublicSupportCY170Pct |
| Public Support PY170 | 0.89360 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | SPECIAL FUNDRAISING EVENTS CHARITABLE GAMING ACTIVITIES | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,021,304 | BeginningYearBalanceAmt |
| Contributions | $440,620 | ContributionsAmt |
| Investment Earnings Or Losses | $176,379 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $176,379 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $7,461,924 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,873,869 | BeginningYearBalanceAmt |
| Contributions | $1,147,435 | ContributionsAmt |
| Investment Earnings Or Losses | $2,689 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $936 | OtherExpendituresAmt |
| Administrative Expenses | $1,753 | AdministrativeExpensesAmt |
| End Year Balance | $7,021,304 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,159,988 | BeginningYearBalanceAmt |
| Contributions | $629,670 | ContributionsAmt |
| Investment Earnings Or Losses | $114,473 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $28,627 | OtherExpendituresAmt |
| Administrative Expenses | $1,635 | AdministrativeExpensesAmt |
| End Year Balance | $5,873,869 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,528,949 | BeginningYearBalanceAmt |
| Contributions | $3,504,360 | ContributionsAmt |
| Investment Earnings Or Losses | $148,437 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $20,121 | OtherExpendituresAmt |
| Administrative Expenses | $1,637 | AdministrativeExpensesAmt |
| End Year Balance | $5,159,988 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,456,169 | BeginningYearBalanceAmt |
| Contributions | $20,090 | ContributionsAmt |
| Investment Earnings Or Losses | $64,733 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $12,043 | OtherExpendituresAmt |
| End Year Balance | $1,528,949 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.55950 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.40290 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.03760 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,697 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,697 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| PLEDGE RECEIVABLE FROM RIDGEVIEW MEDICAL CENTER | $2,241,518 |
| ANNUITY CONTRACT | $55,613 |
| ASSETS HELD IN CHARITABLE REMAINDER TRUST | $370,135 |
| CASH SURRENDER VALUE LIFE INSURANCE POLICY | $2,477,161 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,144,427 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,086,093 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $259,360 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $645,440 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $1,851,767 | OtherRevenueAmt |
| Revenue Not Reported | $2,756,567 | RevenueNotReportedAmt |
| Revenue Subtotal | $329,526 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,954,669 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,954,669 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,284,195 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,140,438 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $645,440 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $376,749 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,022,189 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,118,249 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,118,249 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TO SATISFY THE RESTRICTIONS OF DONORS. |
| PART X, LINE 2: | THE FOUNDATION HAS RECEIVED NOTIFICATION THAT IT QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING PROVISIONS OF STATE LAW AND, ACCORDINGLY, IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, ANY UNRELATED BUSINESS INCOME MAY BE SUBJECT TO TAXATION. DURING 2010, THE FOUNDATION REQUESTED AND WAS APPROVED TO RECLASSIFY FROM 509(A)(3) STATUS TO 509(A)(1) AND 170(B)(1)(A)(VI) STATUS WITH THE IRS. THE FOUNDATION HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE FOUNDATION FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAD NO EFFECT ON THE FINANCIAL STATEMENTS. THE FOUNDATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTION 1,475,018. FUNDRAISING EVENT EXPENSES 363,044. CHARITABLE GAMING EVENT EXPENSES 13,705. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | TEMPORARILY RESTRICTED CONTRIBUTIONS 1,019,857. EVENT PROCEEDS 706,845. PERMANENTLY RESTRICTED CONTRIBUTIONS 227,967. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 363,044. CHARITABLE GAMING EVENT EXPENSES 13,705. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $502,111 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $450,078 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $52,033 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $16,870 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $234,625 | OtherDirectExpensesEvent1Amt |
| Event2 | FALL HARVEST MOON | Event2Nm |
| Gross Receipts Event2 | $204,734 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $200,819 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $3,915 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $60,078 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $706,845 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $650,897 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $55,948 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $16,870 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $294,703 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $311,573 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$255,625 | NetIncomeSummaryAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | MN | StatesWhereGamingConductedCd |
| Licensed | Yes (1) | LicensedInd |
| License Suspended Etc | 0 | LicenseSuspendedEtcInd |
| Gaming With Nonmembers | 0 | GamingWithNonmembersInd |
| Member Of Other Entity | 0 | MemberOfOtherEntityInd |
| Gaming Own Facility | 1.00000 | GamingOwnFacilityPct |
| Individual With Books | GORDON GABLENZ | IndividualWithBooksNm |
Persons With Books US Address PersonsWithBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 SOUTH MAPLE STREET | AddressLine1Txt |
| City | WACONIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55387 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct With3rd Prty For Game Rev | 0 | CntrctWith3rdPrtyForGameRevInd |
| Gaming Manager Person | JAN HELD | GamingManagerPersonNm |
| Gaming Manager Services Prov | JAN HELD IS THE EVENTS COORDINATOR FOR THE FOUNDATION. SHE SUPERVISES ALL FUNDRAISING EVENTS AND FILLS OUT ALL OF THE PAPERWORK RELATED TO GAMING ACTIVITIES. | GamingManagerServicesProvTxt |
| Gaming Manager Is Employee | Yes (X) | GamingManagerIsEmployeeInd |
| Charitable Distribution Rqr | Yes (1) | CharitableDistributionRqrInd |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIDGEVIEW MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 SOUTH MAPLE STREET | AddressLine1Txt |
| City | WACONIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55387 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 311667875 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $1,507,664 | CashGrantAmt |
| Purpose Of Grant | FUNDRAISING SUPPORT OF RIDGEVIEW MEDICAL CENTER | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 17 | RecipientCnt |
| Cash Grant | $17,000 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS AND OTHER ASSISTANCE TO ENTITIES IN THE U.S.: TRANSFERS ARE TO RELATED ENTITIES UNDER COMMON MANAGEMENT AND TRACKED THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS. GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS IN THE U.S.: SCHOLARSHIP PAYMENTS ARE MADE DIRECTLY TO THE SCHOOL THAT THE STUDENT IS ATTENDING. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT STEVENS | ||||||||||||||
| PRESIDENT / CEO | $0 | $430,374 | $0 | $0 | $0 | $2,890 | $0 | $9,873 | $0 | $13,218 | $0 | $456,355 | $0 | $0 |
| GORDON GABLENZ | ||||||||||||||
| CFO & CIO | $0 | $300,816 | $0 | $0 | $0 | $320,127 | $0 | $10,600 | $0 | $14,689 | $0 | $646,232 | $0 | $0 |
| DOUGLAS STASEK | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $196,324 | $0 | $0 | $0 | $19,321 | $0 | $7,111 | $0 | $25,295 | $0 | $248,051 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE PRESIDENT/CEO IS COMPENSATED BY RIDGEVIEW MEDICAL CENTER, THE SOLE MEMBER. THE FOLLOWING WERE USED BY RIDGEVIEW MEDICAL CENTER TO DETERMINE THE PRESIDENT/CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACT 5) COMPENSATION SURVEY OR STUDY 6) APROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | ROBERT STEVENS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT SPLIT-DOLLAR WHOLE LIFE PLAN AT RIDGEVIEW MEDICAL CENTER THAT ACCRUED $254,368 DURING 2015. GORDON GABLENZ PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT SPLIT-DOLLAR WHOLE LIFE PLAN AT RIDGEVIEW MEDICAL CENTER THAT ACCRUED $506,054 DURING 2015. THESE DEFERRED COMPENSATION AMOUNTS ARE REPORTED ON A PRO-RATA BASIS WITHOUT REGARD TO THE INDIVIDUAL'S VESTING SCHEDULE. CURRENTLY, THE MAJORITY OF DEFERRED COMPENSATION IS NOT VESTED. |
| PART I, LINE 6 | THE OFFICERS OF RIDGEVIEW MEDICAL CENTER AND AFFILIATES RECEIVE BONUSES CONTINGENT ON THE NET EARNINGS OF THE CONSOLIDATED ENTITY. |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $3,825 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 10 | ContributionCnt |
| Noncash Contributions Rpt F990 | $55,768 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 8 | ContributionCnt |
| Noncash Contributions Rpt F990 | $2,438 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | AUCTION ITEMS | 429 | $175,851 | FAIR MARKET VALUE |
| Yes (X) | GIFTS | 109 | $169,500 | FAIR MARKET VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBERS REPORTED IN PART I, COLUMN B, LINES 9 AND 19 ARE THE NUMBER OF DONATIONS RECEIVED. THE NUMBERS REPORTED IN PART I, COLUMN B, LINES 25 AND 26 ARE THE NUMBER DONATED ITEMS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE BOARD OF DIRECTORS OF THE FOUNDATION DESIGNATED SEVEN BOARD MEMBERS AS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE ACTS ONLY DURING INTERVALS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS OF THE FOUNDATION AND IS AT ALL TIMES SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS OF THE FOUNDATION. DURING SUCH INTERVALS AND SUBJECT TO SUCH CONTROL AND DIRECTION, THE EXECUTIVE COMMITTEE HAS ALL OF THE AUTHORITY AND POWER OF THE BOARD OF DIRECTORS OF THE FOUNDATION IN THE MANAGEMENT OF THE BUSINESS OF THE FOUNDATION, SUBJECT TO SUCH LIMITATIONS AS THE BOARD OF DIRECTORS OF THE FOUNDATION MAY IMPOSE FROM TIME TO TIME. |
| FORM 990, PART VI, SECTION A, LINE 6 | RIDGEVIEW MEDICAL CENTER IS THE SOLE MEMBER OF RIDGEVIEW FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH PERSON ELECTED BY THE BOARD OF DIRECTORS OF RIDGEVIEW FOUNDATION IS RATIFIED OR REJECTED BY THE BOARD OF DIRECTORS OF RIDGEVIEW MEDICAL CENTER, THE FOUNDATION'S SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | IN ADDITION TO THE APPOINTMENT OF DIRECTORS TO THE BOARD OF DIRECTORS OF RIDGEVIEW FOUNDATION, AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FOUNDATION REQUIRE APPROVAL OF RIDGEVIEW MEDICAL CENTER, THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO REVIEWED THE FORM 990 AND PROVIDED COPIES TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS ANNUALLY REVIEW AND SIGN THE STATEMENTS FOR POTENTIAL CONFLICTS OF INTEREST POLICY. EACH MEMBER IS EXPECTED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THE SITUATION WILL BE EXAMINED AND HANDLED APPROPRIATELY BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | ANY COMPENSATION RECEIVED BY OFFICERS OR BOARD MEMBERS OF RIDGEVIEW FOUNDATION IS DETERMINED BY RIDGEVIEW MEDICAL CENTER, THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION C, LINE 19 | RIDGEVIEW FOUNDATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RIDGEVIEW CLINICS | |||||||||||
| 500 SOUTH MAPLE STREET | WACONIA | MN | 55387 | 411651783 | HEALTH CARE SERVICES | MN | 501(C)(3) | LINE 3 | RIDGEVIEW MEDICAL CENTER | 0 | |
| RIDGEVIEW MEDICAL CENTER | |||||||||||
| 500 SOUTH MAPLE STREET | WACONIA | MN | 55387 | 311667875 | HEALTH CARE SERVICES | MN | 501(C)(3) | LINE 3 | 0 | N/A | |
| RIDGEVIEW INSURANCE COMPANY | |||||||||||
| 60 E SOUTH TEMPLE STE 1800 | SALT LAKE CITY | UT | 84111 | 454109041 | CAPTIVE INSURANCE COMPANY | UT | 501(C)(3) | LINE 12A, I | RIDGEVIEW MEDICAL CENTER | 0 | |
| SIBLEY MEDICAL CENTER | |||||||||||
| 601 W CHANDLER ST | ARLINGTON | MN | 55307 | 411801967 | CRITICAL ACCESS HOSPITAL | MN | 501(C)(3) | LINE 3 | RIDGEVIEW MEDICAL CENTER | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| MINNEAPOLIS HEART INSTITUTE AT RIDGEVIEW HEART CENTER LCC | |||||||
| 500 S MAPLE ST | WACONIA | MN | 55387 | 205785920 | CARDIOLOGY SERVICES | MN | N/A |
| CHASKA PLAZA SURGERY CENTER | |||||||
| 3000 HUNDERTMARK ROAD | CHASKA | MN | 55318 | 450975783 | SURGERY SERVICES | MN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| EXECUTIVE HEALTH MANAGEMENT SERVICES | |||||||||
| 500 SOUTH MAPLE STREET | WACONIA | MN | 55387 | 411760239 | MANAGEMENT SERVICES | MN | N/A | C | 0 |
| CHARITABLE REMAINDER UNITRUST (1) | |||||||||
| CHARITABLE TRUST | MN | 0 | |||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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