ALLINA HEALTH FOUNDATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
ALLINA HEALTH FOUNDATION (EIN 27-4116873)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-09
IRS object ID
201613149349302116
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-09T13:46:05-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN274116873EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALLINA ASSOCIATED FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlALLIBusinessNameControlTxt
Phone6122620660PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 43 MR 10890AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554400043ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICHARD E MAGNUSONPersonNm
Person TitleSENIOR VP FINANCE & TREASURYPersonTitleTxt
Phone6122620660PhoneNum
Signature2016-11-09SignatureDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJAN MALCOLMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 43 MR 10890AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554400043ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,027,675GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO 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.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers218TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,680,028PYContributionsGrantsAmt
CY Contributions Grants$4,804,384CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$26,765PYInvestmentIncomeAmt
CY Investment Income$42,963CYInvestmentIncomeAmt
PY Other Revenue$29,702PYOtherRevenueAmt
CY Other Revenue$23,323CYOtherRevenueAmt
PY Total Revenue$4,736,495PYTotalRevenueAmt
CY Total Revenue$4,870,670CYTotalRevenueAmt
PY Grants And Similar Paid$2,722,747PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,634,082CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$48,140PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$18,482CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,025,926CYTotalFundraisingExpenseAmt
PY Other Expenses$1,529,229PYOtherExpensesAmt
CY Other Expenses$1,594,963CYOtherExpensesAmt
PY Total Expenses$4,300,116PYTotalExpensesAmt
CY Total Expenses$3,247,527CYTotalExpensesAmt
PY Revenues Less Expenses$436,379PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,623,143CYRevenuesLessExpensesAmt
Total Assets BOY$5,343,114TotalAssetsBOYAmt
Total Assets EOY$6,864,972TotalAssetsEOYAmt
Total Liabilities BOY$84,838TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,447TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,258,276NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,858,525NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,235,333ExpenseAmt
Grant$1,235,333GrantAmt
DescHOSPITAL AND MEDICAL CENTER GENERAL OPERATIONS: $1,235,333.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.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$266,542ExpenseAmt
Grant$266,542GrantAmt
DescHOSPITAL AND MEDICAL CENTER CAPITAL EXPANSION : $266,542:IN 2015, ALLINA ASSOCIATED FOUNDATION PROVIDED $266,542 FOR CAPITAL EXPANSION PROJECTS FOR AREA HOSPITALS AND MEDICAL CENTERS AND FOR A TWELVE-BED RESIDENTIAL HOSPICE IN BROOKLYN PARK. THE FOLLOWING ARE EXAMPLES OF SOME OF THE 2015 CAPITAL GRANTS. J.A.WEDUM RESIDENTIAL HOSPICE - 2015 GRANT $104,946THE J.A. WEDUM RESIDENTIAL HOSPICE IS DESIGNED FOR PATIENTS WITH A LIFE-LIMITING ILLNESS WHO NEED PROFESSIONAL ROUND-THE-CLOCK CARE. THE WEDUM HOSPICE PROVIDES PATIENTS WITH A HOME TO LIVE EACH DAY IN COMFORT, WITH DIGNITY AND SURROUNDED BY LOVE. WEDUM IS A MEDICARE CERTIFIED FACILITY.IN 2015, WEDUM HOSPICE ADDED TWO PLANTER RETAINING WALLS AND MADE ADDITIONAL LANDSCAPING IMPROVEMENTS . OWATONNA HOSPITAL -2015 GRANT $76,025OWATONNA HOSPITAL CONVERTED AND REMODELED WHAT WAS FORMERLY THE MEDICAL RECORDS OFFICE INTO A FOUR ROOM INTEGRATIVE HEALTH SERVICES CLINIC. ACUPUNCTURE AND MEDICAL MASSAGE THERAPY ARE NOW BEING OFFERED ON AN OUTPATIENT BASIS IN THIS AREA. CAMBRIDGE MEDICAL CENTER'S EMERGENCY DEPARTMENT- 2015 GRANT $40,173 THE EMERGENCY ROOM NOW INCLUDES 21 PRIVATE ROOMS, INCLUDING FOUR TRAUMA/CARDIAC ROOMS SPECIALLY DESIGNED FOR CRITICALLY ILL PATIENTS, A DECONTAMINATION ROOM, AND FOUR ROOMS FOR PATIENTS NEEDING A SAFE ENVIRONMENT. SPECIAL SPACES FOR FAMILIES ARE AVAILABLE AND THE ENTIRE FACILITY IS DESIGNED TO PROVIDE CARE IN A QUIET AND CALMING ENVIRONMENT.RIVER FALLS AREA HOSPITAL-2015 GRANT $30,734IN 2015, RIVER FALLS AREA HOSPITAL PURCHASED A SIMULATION MANIKIN, USED FOR SIMULATION TRAINING. SIMULATION TRAINING IS A SAFE AND EFFECTIVE WAY FOR EMPLOYEES TO PRACTICE AND IMPROVE THEIR SKILLS, KNOWLEDGE AND TEAMWORK. DURING A SIMULATION, STAFF FROM DEPARTMENTS ACROSS THE HOSPITAL -NURSING, LABORATORY, RADIOLOGY, AND PHARMACY COME TOGETHER TO DRILL IN A CRISIS SETTING.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$110,764ExpenseAmt
Grant$110,764GrantAmt
DescHOUSING/LIVING, MEDICAL, AND EDUCATIONAL ASSISTANCE TO CO-WORKERS AND PATIENTS - $110,764: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. $41,114 IN ASSISTANCE WAS PROVIDED IN 2015.BUFFALO HOSPITAL'S "CARING FOR CO-WORKERS" PROVIDES CONFIDENTIAL EMERGENCY ASSISTANCE TO HOSPITAL EMPLOYEES WHO SUFFER SUDDEN ECONOMIC HARDSHIP AND ARE STRUGGLING TO PAY MEDICAL BILLS, RENT AND OTHER EVERYDAY EXPENSES. $11,627 IN ASSISTANCE WAS PROVIDED IN 2015.BUFFALO AND NEW ULM PROVIDED $11,250 AND $12,000, RESPECTIVELY IN EDUCATIONAL SCHOLARSHIPS IN 2015.OWATONNA PROVIDED $9,365 TO SUPPORT THE "HOPE FUND AND "EMPLOYEE EMERGENCY FUND".RIVER FALLS PROVIDED $21,113 TO SUPPORT "CANCER PATIENT ASSISTANCE AND EDUCATIONAL SCHOLARSHIPS.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$21,443ExpenseAmt
Grant$21,443GrantAmt
DescEXTERNAL GRANTS-2015 GRANT $21,443 THE FOLLOWING ARE SOME EXAMPLES OF EXTERNAL PROGRAMS SUPPORTED IN 2015: $10,258 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.$7,975 WAS PROVIDED TO FREE CLINIC OF STEELE COUNTY. GRANTS PROVIDED TO SUPPORT GENERAL CLINIC OPERATIONS.$3,010 WAS PROVIDED TO THE OWATONNA ART CENTER FOR THE BREAST CANCER SUPERHERO PROJECT. ADDITIONALLY,A $200 GRANT WAS PAID TO SUPPORT AN EVENT MEMORALIZING THE LOSS OF CHILDREN'S LIVES.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$21,443TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$21,443TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$1,634,082TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document1IRPDocumentCnt
IRP Document W2 G1IRPDocumentW2GCnt
Backup Wthld Compliance0BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
DAF Excess Business Holdings0DAFExcessBusinessHoldingsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TAX SERVICES MR 10890BusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6122620660PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12925 CHICAGO AVENUEAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554071321ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DUKE ADAMSKI
DIRECTOR/PRESIDENT2.0040.00Yes (X)Yes (X)$0$1,286,258$18,034
DAVID ALBRECHT
DIRECTOR2.0040.00Yes (X)$0$251,919$61,842
KATHLEEN BACKER
DIRECTOR/SECRETARY2.0040.00Yes (X)$0$0$0
COURTNEY BAECHLER MD
DIRECTOR2.0040.00Yes (X)$0$518,162$98,869
STEPHEN BARITEAU
DIRECTOR2.0040.00Yes (X)$0$246,437$57,731
MATT DRAWZ
DIRECOR/VICE CHAIR2.000.00Yes (X)$0$0$0
TOBY FREIER
DIRECTOR2.0040.00Yes (X)$0$286,004$71,737
PATRICIA HACKMAN
DIRECTOR/TREASURER2.0040.00Yes (X)$0$42,180$25,839
JAN MALCOLM
DIRECTOR/PRESIDENT2.0040.00Yes (X)Yes (X)$0$311,016$58,358
CHRIS MILLER
DIRECTOR2.000.00Yes (X)$0$0$0
DAVID MILLER
DIRECTOR2.0040.00Yes (X)$0$309,736$63,385
JENNIFER MYSTER
DIRECTOR2.0040.00Yes (X)$0$351,905$62,088
JENNIFER O'NEILL
DIRECTOR/CHAIR2.000.00Yes (X)$0$0$0
GARY SHAW
DIRECTOR2.0040.00Yes (X)$0$431,194$62,349
PAUL SMITH
DIRECTOR2.000.00Yes (X)$0$0$0
ROBERT WALTERS
DIRECTOR2.0040.00Yes (X)$0$291,327$62,742
DUNCAN GALLAGHER
CFO2.0040.00Yes (X)$0$1,267,061$347,662
RICHARD MEYER
FORMER DIR./VICE CHAIR/TREAS0.0040.00$0$325,511$70,431Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,918,710TotReportableCompRltdOrgAmt
Total Other Compensation$1,061,067TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$14,303FederatedCampaignsAmt
Fundraising$386,148FundraisingAmt
Related Organizations$1,244,579RelatedOrganizationsAmt
All Other Contributions$3,159,354AllOtherContributionsAmt
Noncash Contributions$844,963NoncashContributionsAmt
Total Contributions$4,804,384TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$75,675TotalRevenueColumnAmt
Exclusion$75,675ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,971,899SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,004,611SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$32,712SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$32,712TotalRevenueColumnAmt
Exclusion-$32,712ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$167,042FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$386,148ContriRptFundraisingEventAmt
Fundraising Direct Expenses$144,901FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,141TotalRevenueColumnAmt
Exclusion$22,141ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$8,675GamingGrossIncomeAmt
Gaming Direct Expenses$7,493GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,182TotalRevenueColumnAmt
Exclusion$1,182ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,870,670TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$66,286ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,523,318TotalAmt
Program Services$1,523,318ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$110,764TotalAmt
Program Services$110,764ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,080TotalAmt
Management And General$9,080ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$18,482TotalAmt
Fundraising$18,482FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$59,026TotalAmt
Management And General$19,479ManagementAndGeneralAmt
Fundraising$39,547FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$73,816TotalAmt
Management And General$24,359ManagementAndGeneralAmt
Fundraising$49,457FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$15,077TotalAmt
Management And General$4,975ManagementAndGeneralAmt
Fundraising$10,102FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$46,124TotalAmt
Management And General$15,221ManagementAndGeneralAmt
Fundraising$30,903FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,272TotalAmt
Management And General$750ManagementAndGeneralAmt
Fundraising$1,522FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
STAFF SERVICES$1,036,686$300,639$736,047
PURCH SVCS-AFFILIATES$343,949$210,068$133,881
MISCELLANEOUS$8,933$2,948$5,985

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,247,527TotalAmt
Program Services$1,634,082ProgramServicesAmt
Management And General$587,519ManagementAndGeneralAmt
Fundraising$1,025,926FundraisingAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$258,743BOYAmt
EOY$369,507EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$5,073,057BOYAmt
EOY$5,322,424EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,314BOYAmt
EOY$1,173,041EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,343,114BOYAmt
EOY$6,864,972EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$84,838BOYAmt
EOY$6,447EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$84,838BOYAmt
EOY$6,447EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,612,112BOYAmt
EOY$3,449,528EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,646,164BOYAmt
EOY$3,408,997EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,258,276BOYAmt
EOY$6,858,525EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,343,114BOYAmt
EOY$6,864,972EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,623,143ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$22,894NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ALLINA HEALTH SYSBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN363261413EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$1,501,875SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$1,501,875SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported OrgYes (1)SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgYes (1)OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV SECTION A LINE 6FROM TIME TO TIME ALLINA ASSOCIATED FOUNDATION SUPPORTS OTHER NON-PROFIT 501(C)(3) ORGANIZATIONS OR NON-PROFIT GOVERNMENTAL ORGANIZATIONS THAT SUPPORT AND OR CARRY OUT THE 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 ALLINA ASSOCIATED FOUNDATION THAT ARE ORGANIZED TO CARRY OUT OR SUPPORT THE PURPOSES, VALUES AND VISION OF ALLINA HEALTH SYSTEM .
PART IV SECTION B LINE 2FROM 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 GOVERNMENTS, FOR ORGANIZATIONS BENEFITED BY ALLINA ASSOCIATED FOUNDATION THAT ARE OPERATED TO CARRY OUT 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.

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (6 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
CASH EQUIVALENTS$503,006F
FIXED INCOME SECURITIES$4,706,398F
EQUITY SECURITIES$26,566F
FUNDS OF HEDGE FUNDS$13,706F
MONEY MARKET$51,677F
COMMODITIES AND OTHER$21,071F
FieldValueIRS element (for citing)
Total Book Value Securities$5,322,424TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
CHARITABLE GIFT ANNUITY$10,346
DUE FROM AFFILIATE$1,162,695
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,173,041TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescCHAR GIFT ANNUITY OBLIGDesc
Amt$6,447Amt
FieldValueIRS element (for citing)
Total Liability$6,447TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,847,776TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$22,894NetUnrealizedGainsInvstAmt
Revenue Not Reported-$22,894RevenueNotReportedAmt
Revenue Subtotal$4,870,670RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,870,670TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,247,527TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$3,247,527ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,247,527TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
Explanation"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."ExplanationTxt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Solicitation Of Govt GrantsYes (X)SolicitationOfGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

FieldValueIRS element (for citing)
Business Name Line1RUFFALO NOEL LEVITZBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11025 KIRKWOOD PARKWAY SWAddressLine1Txt
CityCEDAR RAPIDSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52404ZIPCd
FieldValueIRS element (for citing)
ActivityTELEFUNDRAISINGActivityTxt
Fundraiser Control Of Funds0FundraiserControlOfFundsInd
Gross Receipts$33,320GrossReceiptsAmt
Retained By Contractor$18,482RetainedByContractorAmt
Net To Organization$14,838NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Gross Receipts$33,320TotalGrossReceiptsAmt
Total Retained By Contractors$18,482TotalRetainedByContractorsAmt
Total Net To Organization$14,838TotalNetToOrganizationAmt
Licensed StatesMNLicensedStatesCd
Licensed StatesWILicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event12015 HOSPICE GALAEvent1Nm
Gross Receipts Event1$153,399GrossReceiptsEvent1Amt
Charitable Contri Event1$106,087CharitableContriEvent1Amt
Gross Revenue Event1$47,312GrossRevenueEvent1Amt
Non Cash Prizes Event1$1,200NonCashPrizesEvent1Amt
Food And Beverage Event1$26,977FoodAndBeverageEvent1Amt
Entertainment Event1$550EntertainmentEvent1Amt
Other Direct Expenses Event1$2,575OtherDirectExpensesEvent1Amt
Event22015 SPRING TONIC BUFFALO GALAEvent2Nm
Gross Receipts Event2$121,920GrossReceiptsEvent2Amt
Charitable Contri Event2$103,343CharitableContriEvent2Amt
Gross Revenue Event2$18,577GrossRevenueEvent2Amt
Non Cash Prizes Event2$2,384NonCashPrizesEvent2Amt
Rent Facility Costs Event2$5,886RentFacilityCostsEvent2Amt
Food And Beverage Event2$16,047FoodAndBeverageEvent2Amt
Entertainment Event2$6,000EntertainmentEvent2Amt
Other Direct Expenses Event2$6,537OtherDirectExpensesEvent2Amt
Other Events Total8OtherEventsTotalCnt
Gross Receipts Other Events$277,871GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$176,718CharitableContriOtherEventsAmt
Gross Revenue Other Events$101,153GrossRevenueOtherEventsAmt
Non Cash Prizes Other Events$4,975NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events$2,713RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$30,811FoodAndBeverageOtherEventsAmt
Entertainment Other Events$13,850EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$24,395OthDirectExpnssOtherEventsAmt
Gross Receipts Total$553,190GrossReceiptsTotalAmt
Charitable Contributions Tot$386,148CharitableContributionsTotAmt
Gross Revenue Total Events$167,042GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$8,559NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$8,599RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$73,835FoodAndBeverageTotalEventsAmt
Entertainment Total Events$20,400EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$33,507OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$144,900DirectExpenseSummaryEventsAmt
Net Income Summary$22,142NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
ALLINA HEALTH SYSTEM (DBA BUFFALO HOSPITAL)
2925 CHICAGO AVENUEMINNEAPOLISMN55407363261413170(B)(1)(A)(III)$97,015GENERAL OPERATIONS BUFFALO HOSPITAL AND BIRTH CENTER
ALLINA HEALTH SYSTEM (DBA CAMBRIDGE MEDICAL CENTER)
2925 CHICAGO AVENUEMINNEAPOLISMN55407363261413170(B)(1)(A)(III)$114,117CAMBRIDGE EMERGENCY DEPARTMENT AND GENERAL OPERATIONS CAMBRIDGE MEDICAL CENTER
ALLINA HEALTH SYSTEM ( DBA NEW ULM MEDICAL CENTER )
2925 CHICAGO AVENUEMINNEAPOLISMN55407363261413170(B)(1)(A)(III)$69,477GENERAL OPERATIONS NEW ULM MEDICAL CENTER
ALLINA HEALTH SYSTEM (DBA OWATONNA HOSPITAL)
2925 CHICAGO AVENUEMINNEAPOLISMN55407363261413170(B)(1)(A)(III)$79,813GENERAL OPERATIONS OWATONNA HOSPITAL AND PENNY GEORGE OUTPATIENT CLINIC
ALLINA HEALTH SYSTEM (DBA RIVER FALLS AREA HOSPITAL)
2925 CHICAGO AVENUEMINNEAPOLISMN55407363261413170(B)(1)(A)(III)$95,117RIVER FALLS SIMULATION MANIKIN AND GENERAL OPERATIONS RIVER FALLS AREA HOSPITAL
ALLINA HEALTH SYSTEM (DBA ALLINA HOME CARE HOSPICE & PALLIATIVE CARE)
2925 CHICAGO AVENUEMINNEAPOLISMN55407363261413170(B)(1)(A)(III)$753,547RESIDENTIAL HOSPICE BLDG,INTEGRATIVE THERAPIES, CAPITAL LANDSCAPING IMPROVEMENTS,REIMBURSEMENT PATIENT BILLS
ALLINA HEALTH SYSTEM (DBA PENNY GEORGE INSTITUTE HEALTH & HEALING)
2925 CHICAGO AVENUEMINNEAPOLISMN55407363261413170(B)(1)(A)(III)$292,789PENNY GEORGE INSTITUTE HEALTH AND HEALING OPERATIONS
FREE CLINIC OF STEELE COUNTY
134 SOUTHVIEW STOWANTONNAMN550603241461795200501(C)(3)$7,975SUPPORT GENERAL CLINIC OPERATIONS
FREE CLINIC OF PIERCE AND ST CROIX COUNTIES INC
PO BOX 745RIVER FALLSWI54022205892220501(C)(3)$10,258SUPPORT GENERAL CLINIC OPERATIONS
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (4 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
HOUSING AND LIVING ASSISTANCE138$76,600
MEDICAL / PATIENT CARE13$1,914
RESEARCH AND EDUCATION27$31,250
FUNERAL1$1,000

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALLINA 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract ExceptionYes (1)InitialContractExceptionInd
Rebuttable Presumption ProcYes (1)RebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DUKE ADAMSKI
DIRECTOR/PRESIDENT$0$62,036$0$73,227$0$1,150,995$0$15,805$0$2,229$0$1,304,292$0$105,633
DAVID ALBRECHT
DIRECTOR$0$194,987$0$53,253$0$3,679$0$36,707$0$25,135$0$313,761$0$0
COURTNEY BAECHLER MD
DIRECTOR$0$387,249$0$67,402$0$63,511$0$68,910$0$29,958$0$617,030$0$48,888
STEPHEN BARITEAU
DIRECTOR$0$184,763$0$46,951$0$14,723$0$33,346$0$24,385$0$304,168$0$0
TOBY FREIER
DIRECTOR$0$212,619$0$58,222$0$15,163$0$41,905$0$29,832$0$357,741$0$0
JAN MALCOLM
DIRECTOR/PRESIDENT$0$233,753$0$69,567$0$7,696$0$45,201$0$13,157$0$369,374$0$0
DAVID MILLER
DIRECTOR$0$222,641$0$62,942$0$24,153$0$51,529$0$11,856$0$373,121$0$10,514
JENNIFER MYSTER
DIRECTOR$0$249,828$0$62,429$0$39,648$0$46,547$0$15,541$0$413,993$0$25,676
GARY SHAW
DIRECTOR$0$292,896$0$83,732$0$54,566$0$55,051$0$7,298$0$493,543$0$25,533
ROBERT WALTERS
DIRECTOR$0$236,858$0$24,000$0$30,469$0$35,897$0$26,845$0$354,069$0$0
DUNCAN GALLAGHER
CFO$0$693,692$0$399,138$0$174,231$0$331,447$0$16,215$0$1,614,723$0$318,025
RICHARD MEYER
FORMER DIR./VICE CHAIR/TREAS$0$229,225$0$60,908$0$35,378$0$42,599$0$27,832$0$395,942$0$24,716

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINES 4A-BLINE 4(A): DUKE ADAMSKI - $181,662 LINE 4(B): DUKE ADAMSKI - $943,946; COURTNEY BAECHLER, MD - $45,264; STEPHEN BARITEAU - $11,748; JENNIFER MYSTER - $29,321; GARY SHAW - $23,746; DUNCAN GALLAHER - $102,971; RICHARD MEYER - $26,947.
PART I, LINE 6DEFERRED 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 8CERTAIN 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 M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution17ContributionCnt
Noncash Contributions Rpt F990$844,963NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties UsedYes (1)ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 32B:FormAndLineReferenceDesc
ExplanationALLINA 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.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1C:IN OCTOBER 2015, ALLINA ASSOCIATED 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 AND PRIOR TO OBTAINING THE INFORMATION NECESSARY TO COMPLETE THE FORM W-2G. ALLINA ASSOCIATED FOUNDATION ISSUED AND FILED FORM W-2G AS SOON AS THE INFORMATION NECESSARY TO FILE THE W2-G WAS COLLECTED FROM THE RAFFLE WINNER.
FORM 990, PART VI, SECTION A, LINE 6ALLINA 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 2015 WERE ESTIMATED AT $1,197,975 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 7AAS 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 7BSEE THE EXPLANATION IN SCHEDULE O FOR FORM 990, PART VI, SECTION A, LINE 7A
FORM 990, PART VI, SECTION B, LINE 11ALLINA ASSOCIATED FOUNDATION'S FORM 990 WAS PREPARED BY THE TAX SERVICES FUNCTION OF ALLINA HEALTH SYSTEM, ALLINA ASSOCIATED FOUNDATION'S SOLE CORPORATE MEMBER AND SUPPORTED ORGANIZATION. THE FORM 990 FILING WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA'S TAX MANAGER AND TAX DIRECTOR AND AN EXECUTIVE REVIEW BY ALLINA'S SENIOR VICE PRESIDENT OF FINANCE AND TREASURY. 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 12CTHE 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 15ALLINA 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 19ALLINA 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. PUBLICLY AVAILABLE DATA ON THE FORM 990 WILL ALSO BE AVAILABLE THROUGH AMAZON WEB SERVICES(AWS) AT HTTPS://AWS.AMAZON.COM/PUBLIC-DATA-SETS/IRS-990.
FORM 990, PART XII, LINE 2C:THIS PROCESS REMAINS UNCHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ABBOTT NORTHWESTERN HOSPITAL FOUNDATION
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043043643816SUPPORTING ORGANIZATIONMN501(C)(3)LINE 11A, IALLINA HEALTH SYSTEM0
MERCY & UNITY HOSPITALS FOUNDATION
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043300086426SUPPORTING ORGANIZATIONMN501(C)(3)LINE 11A, IALLINA HEALTH SYSTEM0
PHILLIPS EYE INSTITUTE FOUNDATION
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043411613017SUPPORTING ORGANIZATIONMN501(C)(3)LINE 11A, IALLINA HEALTH SYSTEM0
COURAGE KENNY FOUNDATION
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043411952989SUPPORTING ORGANIZATIONMN501(C)(3)LINE 11A, IALLINA HEALTH SYSTEM0
UNITED HOSPITAL FOUNDATION
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043237420998SUPPORTING ORGANIZATIONMN501(C)(3)LINE 11A, IALLINA HEALTH SYSTEM0
ALLINA HEALTH SYSTEM
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043363261413HEALTHCARE SERVICESMN501(C)(3)LINE 30
MBP FACILITY LLC
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043454078371SUPPORTING ORGANIZATIONMN501(C)(3)LINE 11A, I0N/A
WESTHEALTH INC
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043411768814HEALTHCARE SERVICESMN501(C)(3)LINE 3ALLINA HEALTH SYSTEM0
REGINA FOUNDATION
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043411987372SUPPORTING ORGANIZATIONMN501(C)(3)LINE 11A, I0N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
APPLE VALLEY BUILDING ASSOCIATES LLC
14655 GALAXIE AVENUE SAPPLE VALLEYMN55124411677072RENTAL REAL ESTATEMNN/A
METROPOLITAN INTEGRATED CANCER CENTER LLC
PO BOX 819066DALLASTX75381205068485RADIOLOGYDEN/A
SOUTHWEST SURGICAL CENTER LLC
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043412013700SURGICAL SERVICESMNN/A
MAGNETO LEASING LLC
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043201582501RENTAL EQUIPMENTMNN/A
ASPEN SLEEP CENTERLLC
1010 BANDANA BOULEVARD WESTST PAULMN55108261850227HEALTHCARE SERVICESMNN/A
GERIATRIC SERVICES OF MINNESOTA LLC
3366 OAKDALE AVE NORTH SUITE 551ROBBINSDALEMN55422453357936HEALTHCARE SERVICESMNN/A
NORTHSTAR SLEEP CENTER LLC
920 EAST 28TH STREET SUITE 700MINNEAPOLISMN55407452532456HEALTHCARE SERVICESMNN/A
MOBILE IMAGING SERVICES LLC
1221 NICOLLET MALL STE 600MINNEAPOLISMN554032444411883212RADIOLOGYMNN/A
CROSBY CARDIOVASCULAR SERVICESLLC
920 E 28TH STREET SUITE 500MINNEAPOLISMN55407412010368HEALTHCARE SERVICESMNN/A
BPA HEALTH LLC
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043352490984HEALTHCARE SERVICESMNN/A
TWIN CITIES MEDICAL IMAGING LLC
1221 NICOLLET MALL STE 600MINNEAPOLISMN554032444463959737RADIOLOGYMNN/A
WESTHEALTH SURGERY CENTER LLC
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN554400043371763155SURGICAL SERVICESMNN/A
CT ONE LLC
200 STATE AVENUEFARIBAULTMN55021261187480RADIOLOGYMNN/A
HEALTHCARE CAMPUS IMAGING ONE LLC
200 STATE AVENUEFARIBAULTMN55021522401657RADIOLOGYMNN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
HEALTHSPAN SERVICES COMPANY
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN55440411249999DEBT COLLECTIONMNC0
ALLINA SPECIALTY ASSOCIATES INC
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN55440411802815HEALTHCARE SERVICESMNC0
ALLINA HEALTH SYSTEM TRUST
PO BOX 535007PITTSBURGHPA15253276712988TRUSTPAT0
ALLINA HEALTH SYSTEM DEFINED BENEFIT MASTER TRUST
500 GRANT STREET SUITE 0625PITTSBURGHPA15258376520273TRUSTPAT0N/A
ALLINA HEALTH SYSTEM KEYSHARE PLAN
PO BOX 535007PITTSBURGHPA15253276678945TRUSTPAT0N/A
LIFESPAN AFFILIATES DEFERRED COMPENSATION PLAN
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN55440411720860TRUSTMNT0N/A
ALLINA INTEGRATED MEDICAL NETWORK
PO BOX 43 MAIL ROUTE 10890MINNEAPOLISMN55440275129095HEALTHCARE SERVICESMNC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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