NORTH MEMORIAL FOUNDATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
NORTH MEMORIAL FOUNDATION (EIN 41-1777966)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-08-15
IRS object ID
201402279349303625
Schema version
2013v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2014-08-15T13:51:44-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1225 S 6TH ST 2300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411777966EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone7635205200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1
CityROBBINSDALECity
StateMNState
ZIP Code554222900ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKENT SPAULDINGPersonNm
Person TitleVP FOUNDATIONPersonTitleTxt
Phone7635205200PhoneNum
Signature2014-07-31SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAWRENCE H MOHR CPAPreparerPersonNm
PTINP00447603PTIN
Phone6128764500PhoneNum
Preparation2014-07-31PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENT SPAULDINGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1
CityROBBINSDALECity
StateMNState
ZIP Code554222900ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$2,418,781GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NORTHMEMORIAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO SUPPORT NORTH MEMORIAL HEALTH CARE AND ITS COMMITMENT TO CHANGING AND SAVING LIVES. THROUGH PHILANTHROPY, OUR DONORS ASSIST IN GIVING OUR PATIENTS AND THEIR FAMILIES COMPASSIONATE, REMARKABLE CARE.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers240TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,727,243PYContributionsGrantsAmt
CY Contributions Grants$1,931,145CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$129,781PYInvestmentIncomeAmt
CY Investment Income$102,244CYInvestmentIncomeAmt
PY Other Revenue$49,160PYOtherRevenueAmt
CY Other Revenue$96,397CYOtherRevenueAmt
PY Total Revenue$1,906,184PYTotalRevenueAmt
CY Total Revenue$2,129,786CYTotalRevenueAmt
PY Grants And Similar Paid$946,726PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$926,922CYGrantsAndSimilarPaidAmt
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$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$42,000CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$290,573CYTotalFundraisingExpenseAmt
PY Other Expenses$765,626PYOtherExpensesAmt
CY Other Expenses$656,858CYOtherExpensesAmt
PY Total Expenses$1,712,352PYTotalExpensesAmt
CY Total Expenses$1,625,780CYTotalExpensesAmt
PY Revenues Less Expenses$193,832PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$504,006CYRevenuesLessExpensesAmt
Total Assets BOY$6,349,565TotalAssetsBOYAmt
Total Assets EOY$7,657,063TotalAssetsEOYAmt
Total Liabilities BOY$283,837TotalLiabilitiesBOYAmt
Total Liabilities EOY$278,019TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,065,728NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,379,044NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO SUPPORT NORTH MEMORIAL HEALTH CARE AND ITS COMMITMENT TO CHANGING AND SAVING LIVES. THROUGH PHILANTHROPY, OUR DONORS ASSIST IN GIVING OUR PATIENTS AND THEIR FAMILIES COMPASSIONATE, REMARKABLE CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$314,083ExpenseAmt
Grant$265,806GrantAmt
DescHOSPICE: IN 2013, NORTH MEMORIAL HOSPICE SERVED 1,000 PATIENTS. FOR PATIENTS EXPERIENCING FINANCIAL HARDSHIPS, FOUNDATION DOLLARS PAID FOR UTILITIES, MEDICAL COSTS, EQUIPMENT, AND OTHER EXPENSES. THE FOUNDATION ALSO PAID FOR COSTS ASSOCIATED WITH HOSPICE PATIENTS RECEIVING MASSAGE AND MUSIC THERAPY SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$289,244ExpenseAmt
Grant$249,195GrantAmt
DescPAY IT FORWARD FUND: THIS FUND WAS ESTABLISHED BY BREAST CANCER SURVIVOR, MICHELLE MOREY AND HER HUSBAND SCOTT BISSEN IN OCTOBER OF 2005. MICHELLE RECOGNIZED THE NEED TO HELP FAMILIES STRUGGLING FINANCIALLY WHILE GOING THROUGH CANCER TREATMENT. IN FEBRUARY OF 2006, THE FIRST PAY IT FORWARD FUNDRAISING EVENT WAS HELD AND OVER THE LAST EIGHT YEARS MORE THAN $1.2M HAS BEEN PAID TOWARD PATIENT BILLS OF CANCER PATIENTS AND THEIR FAMILIES. DURING 2013, THE FUND PROVIDED PATIENT ASSISTANCE IN THE AMOUNT OF $228,599 WITH A MAXIMUM PER PATIENT OF $1,500. PATIENTS ELIGIBLE FOR ASSISTANCE ARE FROM NORTH MEMORIAL, MAPLE GROVE, MERCY, UNITY, MONTICELLO, RIDGEVIEW, AND HENNEPIN COUNTY MEDICAL CENTER. THE FUND IS ADMINISTERED AT NO FEE THROUGH THE FOUNDATION. EACH YEAR THE FUND HELPS NEARLY 200 PATIENTS BUY GROCERIES, PAY THEIR MORTGAGES, HEAT THEIR HOMES, PAY FOR UTILITIES, REPAIR THEIR CARS, AND ASSIST WITH UNFUNDED MEDICAL BILLS. THE FUND HELPS PATIENTS TO PAY EXPENSES SO THEY CAN FOCUS ON WHAT'S REALLY IMPORTANT-GETTING HEALTHY.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$200,119ExpenseAmt
Grant$163,459GrantAmt
DescSAFEJOURNEY PROGRAM: IN RESPONSE TO COMMUNITY NEED AND EMERGENCY AWARENESS OF THE CRUCIAL ROLE HEALTH CARE PROVIDERS CAN PLAY IN ASSISTING ABUSE VICTIMS, NORTH MEMORIAL MEDICAL CENTER DEVELOPED A COMPREHENSIVE RESPONSE TO PROACTIVELY IDENTIFY AND RESPOND TO PATIENTS AT NORTH MEMORIAL AND MAPLE GROVE HOSPITAL WHO ARE SUFFERING FROM FAMILY VIOLENCE. FOUNDED IN 1994, SAFEJOURNEY PROVIDES A VARIETY OF DIRECT SERVICES, ADVOCACY, ASSESSMENT, INTERVENTION, PREVENTION AND EDUCATION TO ASSIST OVER FOURTEEN HUNDRED INDIVIDUAL VICTIMS OF ABUSE AS WELL AS THE LARGER COMMUNITY EACH YEAR. SERVICES FOCUSED ON THE NORTHERN AND WESTERN TWIN CITIES SUBURBS AND MINNEAPOLIS' NORTH SIDE, INCLUDE 24 HOURS/DAY, SEVEN DAYS/WEEK COVERAGE OF THE HOSPITAL, USING SKILLED VOLUNTEERS TO PROVIDE PATIENT ASSESSMENT AND ADVOCACY; TWO WEEKLY SUPPORT GROUPS FOR BATTERED WOMEN; AND COMMUNITY AND PROFESSIONAL EDUCATION.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$359,361ExpenseAmt
Grant$248,462GrantAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$359,361TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$248,462TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$1,162,807TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised FundYes (1)DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
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 Individuals0GrantsToIndividualsInd
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
IRP Document35IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
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
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
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 CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TODD OSTENDORFBusinessNameLine1
FieldValueIRS element (for citing)
Phone7635814562PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1
CityROBBINSDALECity
StateMNState
ZIP Code554222900ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DON PARK
TREASURER/INTERIM CHAIR1.000.00Yes (X)Yes (X)$0$0$0
MIKE STEINHAUSER
SECRETARY1.002.00Yes (X)Yes (X)$0$0$0
MARK NIBLICK
BOARD MEMBER1.000.00Yes (X)$0$0$0
TIM CRONIN
BOARD MEMBER1.000.00Yes (X)$0$0$0
LYNN STARKOVICH
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHENG LOR
BOARD MEMBER1.000.00Yes (X)$0$0$0
LOREN TAYLOR
PRESIDENT & CEO3.0050.00Yes (X)Yes (X)$0$776,215$23,125
MICHELLE MOREY
BOARD MEMBER1.000.00Yes (X)$0$0$0
LESLIE BECKER
BOARD MEMBER2.000.00Yes (X)$0$0$0
BRAD BAKKEN
BOARD CHAIR (PART YEAR)2.000.00Yes (X)Yes (X)$0$0$0
STEINAR BERG
BOARD MEMBER2.000.00Yes (X)$0$0$0
JOSEPH G BOSTON
VICE PRESIDENT (PART YEAR)50.000.00Yes (X)$0$408,031$15,408
PATRICK BORAN
VP FINANCE/CFO (PART YEAR)2.0050.00Yes (X)$0$619,221$10,370
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,803,467TotReportableCompRltdOrgAmt
Total Other Compensation$48,903TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$573,658FundraisingAmt
Related Organizations$581,245RelatedOrganizationsAmt
All Other Contributions$776,242AllOtherContributionsAmt
Noncash Contributions$178,676NoncashContributionsAmt
Total Contributions$1,931,145TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$102,244TotalRevenueColumnAmt
Exclusion$102,244ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$385,392FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$573,658ContriRptFundraisingEventAmt
Fundraising Direct Expenses$288,995FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$96,397TotalRevenueColumnAmt
Exclusion$96,397ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,129,786TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$198,641ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$926,922TotalAmt
Program Services$926,922ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$42,000TotalAmt
Fundraising$42,000FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$17,828TotalAmt
Program Services$16,514ProgramServicesAmt
Management And General$1,314ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,070TotalAmt
Program Services$1,070ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,165TotalAmt
Program Services$6,165ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$33TotalAmt
Program Services$33ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
STAFF SUPPORT$539,245$145,386$145,286$248,573
SPONSORSHIPS$63,717$63,717
UNCOLLECTIBLE PLEDGE$25,800$25,800
MISCELLANEOUS$3,000$3,000

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,625,780TotalAmt
Program Services$1,162,807ProgramServicesAmt
Management And General$172,400ManagementAndGeneralAmt
Fundraising$290,573FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$278,870BOYAmt
EOY$214,352EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$480,113BOYAmt
EOY$336,492EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$81,603BOYAmt
EOY$35,748EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$225,000LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$225,000BOYAmt
EOY$225,000EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,295,936BOYAmt
EOY$5,781,800EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$988,043BOYAmt
EOY$1,063,671EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,349,565BOYAmt
EOY$7,657,063EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$260,170BOYAmt
EOY$187,310EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,667BOYAmt
EOY$90,709EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$283,837BOYAmt
EOY$278,019EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,223,030BOYAmt
EOY$1,715,546EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,224,693BOYAmt
EOY$2,334,865EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,618,005BOYAmt
EOY$3,328,633EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,065,728BOYAmt
EOY$7,379,044EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,349,565BOYAmt
EOY$7,657,063EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$504,006ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$809,310NetUnrlzdGainsLossesInvstAmt
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)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,407,544CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,574,278CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,941,680CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,727,243CurrentTaxYearMinus1YearAmt
Current Tax Year$1,931,145CurrentTaxYearAmt
Total$10,581,890TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,407,544CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,574,278CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,941,680CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,727,243CurrentTaxYearMinus1YearAmt
Current Tax Year$1,931,145CurrentTaxYearAmt
Total$10,581,890TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$4,003SubstantialContributorsTotAmt
Public Support Total170$10,577,887PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$79,699CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$80,575CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$117,846CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$87,596CurrentTaxYearMinus1YearAmt
Current Tax Year$102,244CurrentTaxYearAmt
Total$467,960TotalAmt
FieldValueIRS element (for citing)
Total Support$11,049,850TotalSupportAmt
Public Support CY1700.95730PublicSupportCY170Pct
Public Support PY1700.95670PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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)
Donor Advised Funds Held5DonorAdvisedFundsHeldCnt
Donor Advised Funds Contri$131,251DonorAdvisedFundsContriAmt
Donor Advised Funds Grants$64,207DonorAdvisedFundsGrantsAmt
Donor Advised Funds Vl EOY$90,711DonorAdvisedFundsVlEOYAmt
Disclosed Org Leg CtrlYes (1)DisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsYes (1)DisclosedForCharitablePrpsInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,683,970BeginningYearBalanceAmt
Contributions$710,628ContributionsAmt
Investment Earnings Or Losses$85,294InvestmentEarningsOrLossesAmt
Other Expenditures$33,800OtherExpendituresAmt
End Year Balance$3,446,092EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,382,667BeginningYearBalanceAmt
Contributions$270,795ContributionsAmt
Investment Earnings Or Losses$92,571InvestmentEarningsOrLossesAmt
Other Expenditures$62,063OtherExpendituresAmt
End Year Balance$2,683,970EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,251,229BeginningYearBalanceAmt
Contributions$72,500ContributionsAmt
Investment Earnings Or Losses$71,751InvestmentEarningsOrLossesAmt
Other Expenditures$12,813OtherExpendituresAmt
End Year Balance$2,382,667EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,737,891BeginningYearBalanceAmt
Contributions$513,452ContributionsAmt
Investment Earnings Or Losses$25,341InvestmentEarningsOrLossesAmt
Other Expenditures$25,455OtherExpendituresAmt
End Year Balance$2,251,229EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,537,773BeginningYearBalanceAmt
Contributions$58,657ContributionsAmt
Investment Earnings Or Losses$206,326InvestmentEarningsOrLossesAmt
Other Expenditures$64,865OtherExpendituresAmt
End Year Balance$1,737,891EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.96590PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.03410TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$225,000InvestmentCostOrOtherBasisAmt
Book Value$225,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$225,000TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescFUNDS HELD IN TRUST BY OTHERSDesc
Book Value$1,063,671BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,063,671TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEPOSIT ACCOUNTSDesc
Amt$90,709Amt
FieldValueIRS element (for citing)
Total Liability$90,709TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:NORTH MEMORIAL EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2013 OR 2012. NORTH MEMORIAL IS NOT CURRENTLY UNDER EXAMINATION BY ANY TAX JURISDICTION, HOWEVER, WE HAVE BEEN INFORMED BY THE STATE OF MINNESOTA THAT THEY WILL CONDUCT A SALES TAX AUDIT FOR THE PERIOD OF SEPTEMBER 2010 THROUGH DECEMBER 2013.
PART V, LINE 4:1). RALPH ROSSEN ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 1986 TO PROVIDE RECOGNITION TO NURSING STAFF THAT PROVIDE REMARKABLE SERVICE TO NORTH MEMORIAL PATIENTS AND THEIR FAMILIES. MEMBERS OF THE ROSSEN FAMILY SERVE ON A COMMITTEE ALONG WITH THE VP AND CHIEF NURSING OFFICER OF NORTH MEMORIAL TO SELECT THE RECIPIENTS. 2). HAROLD B. KAISER HONORARY LECTURESHIP ENDOWMENT: DR. KAISER IS THE FOUNDER OF ALLERGY & ASTHMA SPECIALISTS, P.A. ESTABLISHED IN 1966. THE HAROLD B. KAISER HONORARY LECTURESHIP ENDOWMENT PROVIDES FUNDING FOR A KEYNOTE SPEAKER FOR THE ANNUAL ALLERGY & ASTHMA CONFERENCE HELD IN THE MINNEAPOLIS AREA IN MARCH. 3). HAROLD ECKER ENDOWMENT: ESTABLISHED IN 1994 IN HONOR OF THE EXCELLENT CARE THAT MR. ECKER RECEIVED AS A PATIENT AT NORTH MEMORIAL, THE HAROLD ECKER ENDOWMENT PROVIDES A $500 AWARD TO THREE NORTH MEMORIAL EMPLOYEES RECOGNIZING THEIR OUTSTANDING PERFORMANCE AND PERSONAL ATTITUDE. THE AWARD IS OPEN TO ALL EMPLOYEES AND THE WINNERS ARE SELECTED BY A COMMITTEE OF NORTH MEMORIAL EMPLOYEES AND PRESENTED AT THE ANNUAL QUALITY AWARDS LUNCHEON IN NOVEMBER EACH YEAR. 4). RESIDENTIAL HOSPICE ENDOWMENT: THE RESIDENTIAL HOSPICE ENDOWMENT WAS ESTABLISHED BY DR. JOHN AND PATTY MANION TO PROVIDE ASSISTANCE TO THE RESIDENTIAL HOSPICE PROGRAM AT NORTH MEMORIAL. FUNDS ARE USED TO UPGRADE THE FACILITIES AND EQUIPMENT AT THE NORTH RESIDENTIAL HOSPICE FACILITY IN BROOKLYN CENTER, PROVIDE ADDITIONAL PROGRAM SUPPORT, STAFF TRAINING AND TO ASSIST THOSE FAMILIES THAT CANNOT AFFORD THIS SERVICE. 5). HELEN MURRAY MEMORIAL ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED WITH AN IRREVOCABLE CHARITABLE REMAINDER TRUST BY JEANNE MITHUN TO RECOGNIZE THE OUTSTANDING SERVICE THAT NORTH RESIDENTIAL HOSPICE PROVIDED TO HER MOTHER (HELEN MURRAY) AND HER FAMILY. FUNDS ARE USED TO PROVIDE CARE TO INDIVIDUALS UNABLE TO PAY FOR SERVICES AT THE FACILITY. 6). PAY IT FORWARD ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 2009 BY FOUNDER MICHELLE MOREY AND THE PIFF COMMITTEE TO INSURE THAT THE GREAT WORK OF THE PAY IT FORWARD FUND CONTINUES WELL INTO THE FUTURE. EACH YEAR THE FUND HELPS MORE THAN 100 PATIENTS PAY THEIR BILLS SO THAT THEY CAN FOCUS ON WHAT'S REALLY IMPORTANT: GETTING HEALTHY. 7). MEDICAL STAFF ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 2010 BY THE NORTH MEMORIAL MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND NORTH MEMORIAL PROGRAMS SUCH AS JUNIOR VOLUNTEER SCHOLARSHIP, SAFEJOURNEY, PASTORAL CARE, ETC. 8). MGH MEDICAL STAFF ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 2013 BY THE MAPLE GROVE MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND MAPLE GROVE PROGRAMS.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
In Person SolicitationsYes (X)InPersonSolicitationsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

FieldValueIRS element (for citing)
Business Name Line1MARK DAVY AND ASSOCIATESBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line14035 BROOKSIDE AVEAddressLine1
CityST LOUIS PARKCity
StateMNState
ZIP Code55416ZIPCode
FieldValueIRS element (for citing)
ActivityCAPITAL CAMPAIGNActivityTxt
Fundraiser Control Of Funds0FundraiserControlOfFundsInd
Gross Receipts$0GrossReceiptsAmt
Retained By Contractor$0RetainedByContractorAmt
Net To Organization$42,000NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Net To Organization$42,000TotalNetToOrganizationAmt
Licensed StatesMNLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1DINNER/DANCE GALANameOfEvent1Amt
Gross Receipts Event1$306,528GrossReceiptsEvent1Amt
Charitable Contri Event1$143,523CharitableContriEvent1Amt
Gross Revenue Event1$163,005GrossRevenueEvent1Amt
Food And Beverage Event1$81,830FoodAndBeverageEvent1Amt
Entertainment Event1$3,600EntertainmentEvent1Amt
Other Direct Expenses Event1$43,570OtherDirectExpensesEvent1Amt
Name Of Event2PAY IT FORWARD CASINO NIGHTNameOfEvent2Amt
Gross Receipts Event2$315,949GrossReceiptsEvent2Amt
Charitable Contri Event2$194,442CharitableContriEvent2Amt
Gross Revenue Event2$121,507GrossRevenueEvent2Amt
Food And Beverage Event2$19,041FoodAndBeverageEvent2Amt
Entertainment Event2$5,300EntertainmentEvent2Amt
Other Direct Expenses Event2$15,708OtherDirectExpensesEvent2Amt
Other Events Total4OtherEventsTotalCnt
Gross Receipts Other Events$336,573GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$235,693CharitableContriOtherEventsAmt
Gross Revenue Other Events$100,880GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events$31,195RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$31,598FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events$57,153OthDirectExpnssOtherEventsAmt
Gross Receipts Total$959,050GrossReceiptsTotalAmt
Charitable Contributions Tot$573,658CharitableContributionsTotAmt
Gross Revenue Total Events$385,392GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$31,195RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$132,469FoodAndBeverageTotalEventsAmt
Entertainment Total Events$8,900EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$116,431OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$288,995DirectExpenseSummaryEventsAmt
Net Income Summary$96,397NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIAL HEALTH CAREBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVE NAddressLine1
CityROBBINSDALECity
StateMNState
ZIP Code55422ZIPCode
FieldValueIRS element (for citing)
Recipient EIN410729979RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$670,801CashGrantAmt
Purpose Of GrantTO SUPPORT NMHC PROGRAMS AND SERVICESPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PRIMARILY MAKES GRANTS TO RELATED ORGANIZATION NORTH MEMORIAL HEALTH CENTER AND RECORDS ARE MAINTAINED AS TO HOW FUNDS ARE DISBURSED BY BOTH ORGANIZATIONS. THE ORGANIZATION ALSO PAID $249,195 THROUGH THE PAY IT FORWARD FUND. ONCE ELIGIBILITY HAS BEEN DETERMINED, THE ORGANIZATION WILL PAY THE PATIENT'S BILLS, SUCH AS MORTGAGE, UTILITIES, REPAIRS, OR UNFUNDED MEDICAL BILLS. EACH PATIENT HAS A MAXIMUM OF $1,500 AND THE BILLS ARE PAID DIRECTLY TO THE VENDORS. THE ORGANIZATION ALSO FUNDS CONTINUING EDUCATION FOR NORTH MEMORIAL EMPLOYEES AND MAKES SEVERAL SMALL SPONSORSHIPS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
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 Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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
LOREN TAYLOR
PRESIDENT & CEO$0$606,008$0$0$0$170,207$0$17,850$0$5,275$0$799,340$0$0
JOSEPH G BOSTON
VICE PRESIDENT (PART YEAR)$0$146,771$0$0$0$261,260$0$10,274$0$5,134$0$423,439$0$0
PATRICK BORAN
VP FINANCE/CFO (PART YEAR)$0$115,113$0$0$0$504,108$0$8,581$0$1,789$0$629,591$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6NORTH MEMORIAL HEALTH CARE'S ANNUAL INCENTIVE PLAN REQUIRES ACHIEVEMENT OF STATED PERFORMANCE METRICS, WHICH INCLUDE OPERATING CASH FLOW MARGIN.
PART I, LINE 1A:THE FOUNDATION DOES NOT COMPENSATE ANY INDIVIDUALS. THE ORGANIZATION RELIED ON NORTH MEMORIAL HEALTH CARE (NMHC) IN SETTING THE COMPENSATION FOR THOSE INDIVIDUALS. NMHC USED THE FOLLOWING METHODS TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE JOSEPH BOSTON - THE DUES FOR 2013 WERE $90/ MONTH OR $1,080 PER YEAR. THE NORTH MEMORIAL FOUNDATION UTILIZES THE COUNTRY CLUB TO HOST VARIOUS FUND-RAISING EVENTS THROUGH-OUT THE YEAR THAT SUPPORTS VARIOUS ACTIVITIES FOR NORTH MEMORIAL.
PART I, LINE 2:ALL EXPENSES ARE REVIEWED PRIOR TO REIMBURSEMENT AND SIGNED OFF BY THE CEO. NORTH MEMORIAL REPORTS EXECUTIVE EXPENSE REIMBURSEMENT DATA TO THE BOARD OF TRUSTEES ON A PERIODIC BASIS.
PART I, LINE 4AA PORTION OF THE AMOUNTS REPORTED IN "OTHER REPORTABLE COMPENSATION" REFLECT PAYMENTS MADE IN 2013 PURSUANT TO SEVERANCE AGREEMENTS WITH 2 EMPLOYEES AS FOLLOWS: PAT BORAN - $425,133 JOE BOSTON - $231,556

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$100NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (6 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)AUCTION ITEMS740$164,601FMV
Yes (X)GOLF BALLS22$6,075FMV
Yes (X)RAFFLE TRIP1$4,000FMV
Yes (X)MEDICAL EQUIP1$2,100FMV
Yes (X)KEYBOARD1$1,500FMV
Yes (X)GIFT CARDS2$300FMV
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationSCHEDULE M, PART I, COLUMN (B) SHOWS THE NUMBER OF CONTRIBUTORS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION TEMPORARILY DELEGATED CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, OR TRUSTEES, OR KEY EMPLOYEES TO A MANAGEMENT COMPANY, MARK DAVY AND ASSOCIATES, AFTER THE PREVIOUS VICE PRESIDENT OF THE FOUNDATION RESIGNED AND WHILE SEARCHING FOR A REPLACEMENT.
FORM 990, PART VI, SECTION A, LINE 6NORTH MEMORIAL HEALTH CARE IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ANORTH MEMORIAL HEALTH CARE, AS THE SOLE MEMBER OF THE ORGANIZATION, DETERMINES THE NUMBER OF BOARD MEMBERS AND ELECTS MEMBERS AT THE ANNUAL MEETING AFTER CONSIDERATION OF NOMINATIONS, IF ANY, FROM THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE APPROVAL OF NORTH MEMORIAL HEALTH CARE AS THE SOLE MEMBER OF THE ORGANIZATION IS REQUIRED FOR THE FOLLOWING ACTIONS OF THE ORGANIZATION'S GOVERNING BODY: (1) AMENDMENTS TO THE GOVERNING DOCUMENTS; (2) MERGER OR CONSOLIDATION OF THE ORGANIZATION; (3) SALE, LEASE, PLEDGE, TRANSFER, ASSIGNMENT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; (4) MORTGAGES OR OTHER SECURITY INTERESTS AFFECTING ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; (5) ISSUANCE OF CAPITAL CALLS TO THE MEMBER; AND (6) DISSOLUTION AND LIQUIDATION OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 WILL BE DISTRIBUTED TO ALL BOARD MEMBERS AT THE MEETING CLOSEST TO THE FILING DATE FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CNORTH MEMORIAL HEALTH CARE HAS A CONFLICT OF INTEREST POLICY THAT COVERS CERTAIN EMPLOYEES, PHYSICIANS AND BOARD MEMBERS. THE NORTH MEMORIAL FOUNDATION BOARD OF DIRECTORS SIGNS AN ANNUAL CONFLICT OF INTEREST STATEMENT IN ACCORDANCE WITH THIS POLICY. IF A BOARD MEMBER DISCLOSES A CONFLICT OF INTEREST, THE INFORMATION IS SENT TO LEGAL COUNSEL FOR EVALUATION. PROCEDURES: THE BOARD OF DIRECTORS AND ITS COMMITTEES SHALL USE THE FOLLOWING PROCEDURES FOR DETERMINING CONFLICTS OF INTEREST AND FOR DECIDING HOW TO PROCEED WHEN CONFLICTS OF INTEREST ARE REVEALED: A. DUTY TO DISCLOSE: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND/OR COMMITTEE MEMBERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. B. DETERMINATION WHETHER A CONFLICT OF INTEREST EXISTS: AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING DIRECTORS OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. C. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: I) AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. II). THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. III). AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE COMPANY CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IV). IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES OR COMMITTEE MEMBERS WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE COMPANY. THE BOARD OR COMMITTEE SHALL THEN MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. D. RECORDING OF PROCEEDINGS: THE MINUTES OF THE BOARD AND ITS COMMITTEES SHOULD INCLUDE: (I) THE NAMES OF ANY PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED, AND (II) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THE PROCEEDINGS.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION'S OFFICERS RECEIVED THEIR COMPENSATION FROM NORTH MEMORIAL HEALTH CARE (NMHC) WHICH FOLLOWS NMHC'S POLICIES AND PROCEDURES ON DETERMINING COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
NORTH MEMORIAL HEALTH CARE
3300 OAKDALE AVE NROBBINSDALEMN55422410729979ACUTE CAREMN501(C)(3)LINE 3NORTH MEMORIAL0
ASSOCIATED HEALTH ASSURANCE
3300 OAKDALE AVE NROBBINSDALEMN55422980343815INSURANCE501(C)(3)11ANORTH MEMORIAL0BD
MAPLE GROVE HOSPITAL CORPORATION
3300 OAKDALE AVE NROBBINSDALEMN55422208316475ACUTE CAREMN501(C)(3)LINE 3NORTH MEMORIAL0
NORTH COLLABORATIVE CARE
3300 OAKDALE AVE NROBBINSDALEMN55422461680666PRIMARY CAREMN501(C)(3)11ANORTH MEMORIAL0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE LLC
9855 HOSPITAL DRIVEMAPLE GROVEMN55369260393039OUTPATIENT SURGERYMNN/A
MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC
2955 XENIUM LANE SUITE 40PLYMOUTHMN55441352162215RADIOLOGYMNN/A
NORTH RADIATION THERAPY CENTER LLC
6950 FRANCE AVE S SUITE 200EDINAMN55435743069974RADIOLOGYMNN/A
BLAINE URGENCY CENTER LLC
480 OSBORNE RDFRIDLEYMN55432461630126URGENT CAREMNN/A
PLYMOUTH CITY CENTER MEDICAL BUIDING
5700 SMETANA DRIVE SUITE 120MINNETONKAMN55343463883617MEDICAL OFFICE BUILDINGMNN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
OAKDALE HEALTH ENTERPRISES INC
3300 OAKDALE AVE NROBBINSDALEMN55422411546422AMBULANCEMNN/AC0
CHARITABLE REMAINDER TRUST (1)
CHARITABLE TRUSTMNT0NORTH MEMORIAL FOUNDATION
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
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

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
NORTH MEMORIAL HEALTH CARE (CONTRIBUTIONS TO NMHC)
B$670,801FMV
NORTH MEMORIAL HEALTH CARE (STAFF SUPPORT)
O$581,245FMV

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