SISU MEDICAL SYSTEMS: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- SISU MEDICAL SYSTEMS (EIN 41-1901561)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-13
- IRS object ID
- 201403179349303985
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-13T14:08:40-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 W FIRST ST STE 700 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 558021919 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411901561 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISU MEDICAL SYSTEMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SISU | BusinessNameControlTxt |
| Phone | 2185297948 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 WEST FIRST STREET SUITE 200 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 55802 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN BOERBOOM | PersonNm |
| Person Title | INTERIM CFO | PersonTitleTxt |
| Phone | 2185297948 | PhoneNum |
| Signature | 2014-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JULIE BOYER | PreparerPersonNm |
| PTIN | P01278549 | PTIN |
| Phone | 2187275025 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SCOTT LEE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 WEST FIRST STREET SUITE 200 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 55802 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $398,578 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SISUNET.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL SOFTWARE/COMPUTER NETWORK SERVICES TO CERTAIN HEALTHCARE FACILITIES IN NORTHERN MINNESOTA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,211,215 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $398,578 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $8,211,215 | PYTotalRevenueAmt |
| CY Total Revenue | $398,578 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,233,700 | PYOtherExpensesAmt |
| CY Other Expenses | $493,190 | CYOtherExpensesAmt |
| PY Total Expenses | $8,233,700 | PYTotalExpensesAmt |
| CY Total Expenses | $493,190 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$22,485 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$94,612 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,110,798 | TotalAssetsBOYAmt |
| Total Assets EOY | $420,273 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,686,234 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $383,643 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,424,564 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $36,630 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE MEDICAL SOFTWARE/COMPUTER NETWORK SERVICES TO CERTAIN HEALTHCARE FACILITIES IN NORTHERN MINNESOTA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $294,746 | ExpenseAmt |
| Revenue | $398,578 | RevenueAmt |
| Desc | SISU MEDICAL SYSTEMS IS A 13 MEMBER CORPORATION ENGAGED PRIMARILY IN THE BUSINESS OF PROVIDING MEDICAL SOFTWARE/COMPUTER NETWORK SERVICES TO CERTAIN NOT FOR PROFIT AND GOVERNMENTAL HEALTHCARE ORGANIZATIONS LOCATED PRIMARILY IN NORTHERN MINNESOTA. THE CORPORATION ALSO SERVES THE MEMBERS AND THEIR COMMUNITIES BY PROVIDING THE MEMBERS THE OPPORTUNITY TO POOL BUYING POWER IN ORDER TO PURCHASE HARDWARE AND SOFTWARE AT PRICING THAT IS COMPETITIVE WITH LARGER HEALTHCARE ORGANIZATIONS. | Desc |
| Total Program Service Expenses | $294,746 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN BOERBOOM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2185297939 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 WEST FIRST STREET SUITE 200 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 55802 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|
| AL VOGT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICK BREUER | |||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MIKE HAGEN | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RANDY ULSETH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAN ODEGAARD | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| STEVEN MUDLER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN FOSSUM | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON DOUGLAS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT NIGON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANK LAWATSCH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHAD COOPER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KIMBER WRAALSTAD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN SOLHEIM | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KRIS OLBERG | |||||||
| CIO | 1.00 | $0 | $56,646 | $3,397 | Yes (X) | 39.00 | |
| DAN RABIDEAUX | |||||||
| FORMER CFO | 1.00 | $0 | $156,663 | $9,975 | Yes (X) | 39.00 | |
| SCOTT LEE | |||||||
| CEO | 1.00 | $0 | $219,897 | $12,900 | Yes (X) | 39.00 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $433,206 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $26,272 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEDICAL INFORMATION TECHNOLOGY INC | BusinessNameLine1 |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 74569 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60696 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | SOFTWARE LICENSING AND IMPLEMENTATION | ServicesDesc |
| Compensation | $569,055 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SOFTWARE/COMP FEES | Desc |
| Business | 541519 | BusinessCd |
| Total Revenue Column | $398,578 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $398,578 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $398,578 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $398,578 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $398,578 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,500 | TotalAmt |
| Management And General | $3,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,768 | TotalAmt |
| Management And General | $3,768 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $915 | TotalAmt |
| Program Services | $58 | ProgramServicesAmt |
| Management And General | $857 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,338 | TotalAmt |
| Program Services | $5,338 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,578 | TotalAmt |
| Management And General | $19,578 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| LICENSES | $271,739 | $222,129 | $49,610 |
| LOSS ON DEBT EXTINGUISH | $121,131 | $121,131 | |
| MAINTENANCE CONTRACTS | $61,144 | $61,144 | |
| LEASED EQUIPMENT | $6,077 | $6,077 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $493,190 | TotalAmt |
| Program Services | $294,746 | ProgramServicesAmt |
| Management And General | $198,444 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $343,881 | BOYAmt |
| EOY | $204,060 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $491,725 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,236,279 | BOYAmt |
| EOY | $213,981 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $428,259 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,940 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,541 | BOYAmt |
| EOY | $2,232 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,293,312 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,861 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,110,798 | BOYAmt |
| EOY | $420,273 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,430,632 | BOYAmt |
| EOY | $354,429 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,028 | BOYAmt |
| EOY | $29,214 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,155,574 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,686,234 | BOYAmt |
| EOY | $383,643 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,424,564 | BOYAmt |
| EOY | $36,630 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,424,564 | BOYAmt |
| EOY | $36,630 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,110,798 | BOYAmt |
| EOY | $420,273 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$94,612 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,293,322 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAN RABIDEAUX | ||||||||||||||
| FORMER CFO | $0 | $155,550 | $0 | $1,113 | $0 | $0 | $0 | $8,748 | $0 | $1,227 | $0 | $166,638 | $0 | $0 |
| SCOTT LEE | ||||||||||||||
| CEO | $0 | $202,397 | $0 | $17,500 | $0 | $0 | $0 | $10,500 | $0 | $2,400 | $0 | $232,797 | $0 | $0 |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | EQUIPMENT, LEASEHOLD IMPROVEMENTS (DETAIL AVAILABLE UPON REQUEST) | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2013-01-01 | DistributionDt |
| Fair Market Value Of Asset | $2,293,312 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | FMV | MethodOfFMVDeterminationTxt |
| EIN | 412008284 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISU MEDICAL SOLUTIONS LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 WEST FIRST STREET SUITE 200 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 55802 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | DOMESTIC LLC | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 0 | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | 0 | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SISU MEDICAL SYSTEMS IS A NONPROFIT MEMBER CORPORATION MADE UP OF 13 FULL MEMBERS AND 1 ASSOCIATE MEMBER. EACH UNRELATED FULL MEMBER HAS ONE SEAT ON THE BOARD OF DIRECTORS AND ONE VOTE. |
| FORM 990, PART VI, SECTION A, LINE 7A | SISU MEDICAL SYSTEMS IS A NONPROFIT MEMBER CORPORATION MADE UP OF 13 FULL MEMBERS AND 1 ASSOCIATE MEMBER. EACH UNRELATED FULL MEMBER HAS ONE SEAT ON THE BOARD OF DIRECTORS AND ONE VOTE. |
| FORM 990, PART VI, SECTION A, LINE 7B | SISU MEDICAL SYSTEMS IS A NONPROFIT MEMBER CORPORATION MADE UP OF 13 FULL MEMBERS AND 1 ASSOCIATE MEMBER. EACH UNRELATED FULL MEMBER HAS ONE SEAT ON THE BOARD OF DIRECTORS AND ONE VOTE. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED BY THE FINANCE COMMITTEE PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | PURPOSE OF CONFLICT OF INTEREST: TO ESTABLISH GUIDELINES REGARDING THE ACCEPTANCE OR SOLICITATION OF GIFTS, MERCHANDISE SAMPLES OR OTHER GRATUITIES BY EMPLOYEES OF SISU FROM PATIENTS, VISITORS, AND REPRESENTATIVES OF COMMERCIAL CONCERNS DOING BUSINESS OR WANTING TO DO BUSINESS WITH SISU OR ITS MEMBERS. THIS POLICY IS NOT INTENDED TO BE EXCLUSIVE AND ADDITIONAL LAWS, REGULATIONS, AND POLICIES MAY BE IMPLICATED IN A GIVEN CONFLICT OF INTEREST SITUATION. THE EMPLOYEES OF SISU MEDICAL SOLUTIONS OR SISU MEDICAL SYSTEMS (HEREAFTER COLLECTIVELY REFERRED TO AS SISU) SERVE THE INTEREST OF ITS MEMBERS AND THEREFORE HAVE A RESPONSIBILITY TO AVOID ACTIVITIES AND SITUATIONS WHICH, EITHER ACTUALLY OR COULD BE PERCEIVED TO PUT PERSONAL INTERESTS BEFORE PROFESSIONAL OBLIGATIONS. POLICY: IT IS THE RESPONSIBILITY OF EACH EMPLOYEE TO COMPLY WITH THE GUIDELINES OF THE POLICY. THE DIRECTORS AND MANAGERS WILL BE RESPONSIBLE FOR THE ENFORCEMENT OF THE POLICY. PROCEDURE: 1. SISU MEDICAL SYSTEMS EMPLOYEES MAY NOT SOLICIT OR ACCEPT MONETARY GIFTS THAT WOULD SUGGEST OR CREATE AN OBLIGATION OF THE ORGANIZATION. 2. UNDER NO CIRCUMSTANCES SHOULD ANY GIFT OR GRATUITY BE ACCEPTED WHICH WOULD INFLUENCE OR COULD BE PERCEIVED TO INFLUENCE THE EMPLOYEE'S PROFESSIONAL JUDGMENT. 3. EMPLOYEES MAY NOT ACCEPT OR SOLICIT SAMPLES OF MERCHANDISE FOR THEIR PERSONAL USE NOR MAY THEY ACCEPT MONEY FROM PATIENTS OR THE GENERAL PUBLIC FOR THEIR SERVICES AS A SISU EMPLOYEE. 4. NON-MONETARY UNSOLICITED GIFTS OF INSIGNIFICANT VALUE (E.G., CALENDARS, PENS, PENCIL, RULES AND SCRATCH PADS) MAY BE ACCEPTED BY EMPLOYEES IF OFFERED FREELY AND DO NOT IMPLY FUTURE OBLIGATION. 5. FLOWERS, CARDS, CANDY, FRUIT OR OTHER SIMILAR EXPRESSIONS OF APPRECIATION WHICH DO NOT IMPLY FUTURE OBLIGATIONS MAY BE ACCEPTED ON BEHALF OF SISU AND SHARED WITH SISU EMPLOYEES. 6. VENDOR PROVIDED ACTIVITIES, SUCH AS SPORTING EVENTS, GOLF, PLAYS, FISHING, HUNTING, ETC. ARE NOT PERMISSIBLE UNLESS APPROVED BY A DIRECTOR. LEISURE ACTIVITIES, ON EMPLOYEES OWN TIME, WILL BE LIMITED TO 2 EVENTS PER YEAR WITH APPROVAL FROM A DIRECTOR. 7. BUSINESS LUNCHES AND DINNERS OFFERED BY A VENDOR THAT SISU IS CURRENTLY DOING BUSINESS WITH, MAY BE ACCEPTED BY AN EMPLOYEE WHEN THEY ARE REASONABLE, ARE ASSOCIATED WITH A BONA FIDE BUSINESS MEETING, AND ARE PROVIDED BY THE VENDOR TO OTHERS AS A NORMAL PART OF ITS BUSINESS. ANY EXCESSIVE MEALS OR ENTERTAINMENT PAID FOR BY A VENDOR MAY NOT BE ACCEPTED. 8. VENDOR-SUPPORTED TRAINING. - SISU EMPLOYEES MAY PARTICIPATE IN VENDOR-SPONSORED TRAINING WHERE THE TRAINING IS DIRECTLY RELATED TO PRODUCT OR SERVICES CURRENTLY BEING USED BY SISU OR ITS MEMBERS. A. IF SPECIFICALLY ADDRESSED IN A WRITTEN CONTRACT BETWEEN SISU OR ITS MEMBERS AND THE VENDOR, THE EMPLOYEE IS ALLOWED TO ACCEPT PAYMENT FOR THE TRAINING COURSE, TRAVEL, LODGING, ETC. 9. SISU EMPLOYEES MAY NOT ACCEPT PAYMENT OR REIMBURSEMENT FOR REGISTRATION FEES, OR RELATED TRAVEL OR LODGING, FOR GENERAL TRADE OR PROFESSIONAL ASSOCIATION CONFERENCES FROM CURRENT OR PROSPECTIVE VENDORS. 10. AN EMPLOYEE WHO RECEIVES A GIFT PROHIBITED BY THESE GUIDELINES, OR IS OFFERED PAYMENT OR REIMBURSEMENT OF REGISTRATION FEE, OR RELATED TRAVEL OR LODGING, SHOULD REPORT THAT INFORMATION TO HIS/HER IMMEDIATE SUPERVISOR. A DECISION WILL BE MADE BY MANAGEMENT TO RESOLVE THE CONFLICT. THE ORGANIZATION'S OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REMINDED ANNUALLY OF THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION DOES NOT COMPENSATE ANY OFFICERS OR KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 18 | FORMS 1023 & 990 ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | DISTRIBUTION TO MEMBER ORGANIZATIONS -2,293,322. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISU MEDICAL SOLUTIONS LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 WEST FIRST STREET SUITE 200 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 55802 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 412008284 | EIN |
| Primary Activities | SISU MEDICAL SOLUTIONS, LLC PROVIDES MANAGEMENT SERVICES TO THE ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (1) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISU MEDICAL SOLUTIONS LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | G | TransactionTypeTxt |
| Involved | $2,293,322 | InvolvedAmt |