2015-05-14T09:15:11-07:00 2014-09-30 990 2013-10-01 411677288 LAKE REGION HEALTHCARE FOUNDATION LAKE 2187368000 712 S CASCADE ST FERGUS FALLS MN 565380728 BRETT LONGTIN CPA SR VP/CFO 2187368000 2015-05-14 2013 2016-02-25 16:41:14Z LARRY DORN 712 S CASCADE ST FERGUS FALLS MN 56537 1920274 0 X X Foundation 2000 MN THE PURPOSE OF THE LAKE REGION HEALTHCARE FOUNDATION IS TO RECEIVE GIFTS AND DONATIONS TO HELP LAKE REGION HEALTHCARE FULFILL IT'S MISSION OF PROVIDING QUALITY HEALTHCARE SERVICES IN A CARING MANNER TO EVERY INDIVIDUAL THEY SERVE. 16 11 0 228 0 0 262519 321930 0 0 518749 705177 17770 10960 799038 1038067 107144 54576 0 0 0 0 0 0 0 150672 1500 257816 56076 541222 981991 11006270 11810853 101 0 11006169 11810853 THE PURPOSE OF THE LAKE REGION HEALTHCARE FOUNDATION IS TO RECEIVE GIFTS AND DONATIONS TO HELP LAKE REGION HEALTHCARE FULFILL IT'S MISSION OF PROVIDING QUALITY HEALTHCARE SERVICES IN A CARING MANNER TO EVERY INDIVIDUAL THEY SERVE. 0 0 56076 54576 689006 LAKE REGION HEALTHCARE FOUNDATION RECEIVED DONATIONS AND MEMORIALS FROM SEVERAL INDIVIDUALS AND BUSINESSES. IT ALSO RECEIVES PLEDGES AND PAYMENTS OF THOSE PLEDGES. THE FOUNDATION USES SOME OF IT'S FUNDS FOR A VARIETY OF PURPOSES WHICH AID LAKE REGION HEALTHCARE AND THE COMMUNITY IN PROVIDING QUALITY HEALTHCARE. 0 0 0 56076 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 X 16 11 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X X X LAKE REGION HEALTHCARE CORPORATION 2187368000 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 LARRY DORN CHAIRMAN 2 0 X 0 0 0 SOLVEIG HALBAKKEN VICE CHAIR 2 0 X 0 0 0 DIC PICKETT SECRETARY/TREASURER 2 0 X 0 0 0 DAVID JOHNSON TRUSTEE 2 0 X 0 0 0 STEPHEN RUFER TRUSTEE 2 0 X 0 0 0 ANDREW YAGGIE TRUSTEE 2 0 X 0 0 0 GARY SPIES TRUSTEE 2 0 X 0 0 0 JOHN ERICKSON TRUSTEE 2 0 X 0 0 0 DAVID BJORK MD TRUSTEE 2 0 X 0 0 0 PAUL ETZELL MD TRUSTEE 2 0 X 0 0 0 LINDA MATTER PHD TRUSTEE 2 0 X 0 0 0 DAVE BICKETT TRUSTEE 2 0 X 0 0 0 TODD MCGOVERN DDS TRUSTEE 2 0 X 0 0 0 LAUREL NELSON TRUSTEE 2 0 X 0 0 0 CRYSTAL ADAMS TRUSTEE 2 0 X 0 0 0 KATHY BURGAU TRUSTEE 2 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321930 92 321930 0 0 0 0 0 567804 0 0 567804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004094 0 866721 0 137373 0 137373 0 0 137373 19865 0 6333 13532 0 13532 0 0 0 0 0 0 6581 9153 -2572 -2572 0 0 0 1038067 -2572 0 718709 X 54576 54576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MISCELLANEOUS EXPENSE 112 112 0 0 BAD DEBTS 1000 1000 0 0 0 0 0 0 56076 56076 0 0 273141 428892 0 0 575645 288877 0 3000 0 0 0 0 0 0 0 0 0 0 10157484 11090084 0 0 0 0 0 0 0 0 11006270 11810853 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 X 11006169 11810853 0 0 0 0 11006169 11810853 11006270 11810853 X 981991 -137390 0 0 0 -39917 X 0 1 X 1 0 X X 1 0 0 LAKE REGION HEALTHCARE CORPORATION 410730602 170(b)(1)(A)(iii) 1 1 1 39917 1 39917 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6624 0 1073 0 3497 0 4200 0 1 1 980856 0 0 0 0 0 980856 0 57211 57211 1038067 70861 0 0 0 15485 15485 55376 0 700 700 56076 Schedule D, Part XI, Line 4b THERE WERE TOTAL CONTRIBUTIONS OF $93,505, ADDITIONAL FUNDRAISING REVENUE OF $700, PRESENT VALUE AND PLEDGE ALLOWANCE ADJUSTMENT OF $(21,508), FUNDRAISING EXPENSE OF $(6,333), AND COST OF GOODS SOLD OF $(9,153). Schedule D, Part XII, Line 2d THERE WAS COST OF GOODS SOLD OF $9,153 AND FUNDRAISING EXPENSE OF $6,332. Schedule D, Part XII, Line 4b THERE WAS ADDITIONAL FUNDRAISING EXPENSE OF $700. PRCA RODEO 16193 0 16193 150 1050 0 0 0 2513 0 0 16193 0 16193 150 1050 0 0 0 2513 3713 12480 1 LAKE REGION HEALTHCARE 712 S CASCADE ST FERGUS FALLS MN 56537 411817549 36990 TO ENHANCE PATIENT SERVICES PROVIDED AT LAKE REGION HEALTHCARE LAKE REGION HOSPITAL AUXILIARY 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 237182604 5755 THE GRANT WAS GIVEN TO ENHANCE SALES IN THE LAKE REGION HEALTHCARE GIFT SHOP. ALL PROCEEDS FROM THE GIFT SHOP ARE GIVEN AS SCHOLARSHIPS TO STUDENTS PURSUING HEALTHCARE CAREERS. MINNESOTA STATE COMMUNITY AND TECHNICAL COLLEGE 1414 COLLEGE WAY FERGUS FALLS MN 56537 411687554 22665 TO PURCAHSE AUDIO/VISUAL TRAINING TOOLS FOR NURSING STUDENTS 3 0 Schedule I, Part I, Line 2 GRANTS AWARDED BY LAKE REGION HEALTHCARE FOUNDATION HAVE TO MEET CERTAIN GUIDELINES WHICH INCLUDE (1) REQUEST MUST BE FOR HEALTH-RELATED PROGRAMS OR PROJECTS, AND MUST BENEFIT INDIVIDUALS LIVING WITHIN THE LRHC SERVICE AREA (2) NO REQUESTS WILL BE ACCEPTED ON BEHALF OF AN INDIVIDUAL OR FAMILY (3) NO GRANTS WILL BE MADE TO INSTITUTIONS WHICH IN POLICY OR PRACTICE DISCRIMINATE ON THE BASIS OF RACE, CREED, GENDER OR SEXUAL ORIENTATION (4) ANY PUBLISHED ARTICLES, PRESS RELEASES, OR INFORMATION RELATED TO THE GRANT RELEASED BY YOUR ORGANIZATION SHOULD STATE THAT THE PROJECT WAS FULLY OR PARTIALLY FUNDED BY DONATIONS TO THE LAKE REGION HEALTHCARE FOUNDATION (5) FUNDS AWARDED MUST BE EXPENSED ONLY FOR STATED PURPOSE ON THE APPLICATION (6) FUNDS MUST BE DISTRIBUTED WITHIN ONE CALENDAR YEAR OF THE AWARD AND (7) DISBURSEMENTS MAY BE DISCONTINUED IF THE PROGRAM OF PROJECT IS DISCONTINUED, OR ITS ORIGINAL PURPOSE IS ALTERED. Form 990, Part VI, Section A, Line 6 LAKE REGION HEALTHCARE CORPORATION IS A SOLE MEMBER. Form 990, Part VI, Section B, Line 11b COPIES OF THE COMPLETED 990, WITH SUPPORTING SCHEDULES AND FOOTNOTES, WILL BE DISTRIBUTED TO ALL THE FOUNDATION BOARD MEMBERS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE DETAILED AND CONSCIENTIOUS REVIEW BY ALL BOARD MEMBERS, CHIEF EXECUTIVE OFFICER, AND CHIEF FINANCIAL OFFICER TO ENABLE AN OPPORTUNITY FOR FEEDBACK AND CORRECTIONS. ALL QUESTIONS, CONCERNS, OR OTHER FEEDBACK FROM BOARD MEMBERS WILL BE DIRECTED TO THE LRHC CHIEF FINANCIAL OFFICER AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE. Form 990, Part VI, Section B, Line 12c OFFICER AND TRUSTEES ANNUALLY ASSESS WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST ACCORDING TO THE CONFLICTS AND INTEREST POLICY. IT IS CONSISTANTLY MONITORED DURING THE YEAR TO BE SURE THAT THE POLICY IS BEING FOLLOWED. Form 990, Part VI, Section C, Line 19 THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part IX, Line 24a - 24d THE BAD DEBT EXPENSE OF $1,000 WAS DUE TO WRITING OFF PLEDGES THAT LAKE REGION HEALTHCARE FOUNDATION DEEMED UNCOLLECTIBLE. Form 990, Part XI, Line 9 THERE WAS A TOTAL OF $(39,917) OF RELATED COMPANY TRANSFERS. LAKE REGION HEALTHCARE CORPORATION 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 410730602 HOSPITAL MN 501(C)(3) N/A 0 LRHC LONG TERM CARE FACILITIES INC 712 S CASCADE ST PO BOX 728 FERGUS FALLS MN 565380728 411817549 ASSISTED LIVING MN 501(C)(3) LAKE REGION HEALTHCARE CORPORATION 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0