NAEVE HEALTH CARE FOUNDATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- NAEVE HEALTH CARE FOUNDATION (EIN 41-1989509)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-08-29
- IRS object ID
- 201412419349300526
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule F
- Schedule G
- Schedule I
- Schedule J
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-08-29T14:00:19-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411989509 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NAEVE HEALTH CARE FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NAEV | BusinessNameControlTxt |
| Phone | 5073776380 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 404 WEST FOUNTAIN ST | AddressLine1 |
| City | ALBERT LEA | City |
| State | MN | State |
| ZIP Code | 56007 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLAIRE VERMEDAHL | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5073776380 | PhoneNum |
| Signature | 2014-08-29 | SignatureDt |
| 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 | CLAIRE VERMEDAHL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 404 WEST FOUNTAIN ST | AddressLine1 |
| City | ALBERT LEA | City |
| State | MN | State |
| ZIP Code | 56007 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,009,289 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP:WWW.NAEVEFOUNDATION.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | RAISING PHILANTHROPIC DOLLARS FOR HIGH QUALITY COST-EFFECTIVE HEALTHCARE AT MCHS IN ALBERT LEA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $61,858 | PYContributionsGrantsAmt |
| CY Contributions Grants | $188,734 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $185,057 | PYInvestmentIncomeAmt |
| CY Investment Income | $327,329 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $13,230 | CYOtherRevenueAmt |
| PY Total Revenue | $246,915 | PYTotalRevenueAmt |
| CY Total Revenue | $529,293 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $329,398 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $279,449 | 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 | $31,676 | PYOtherExpensesAmt |
| CY Other Expenses | $35,032 | CYOtherExpensesAmt |
| PY Total Expenses | $361,074 | PYTotalExpensesAmt |
| CY Total Expenses | $314,481 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$114,159 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $214,812 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,509,151 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,948,808 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,509,151 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,948,808 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O.TO ENSURE THE FUTURE OF LOCAL, QUALITY HEALTH CARE THROUGH THE CONTINUED DEVELOPMENT OF A PERMANENT ENDOWMENT FUND AND OTHER PHILANTHROPIC RELATIONSHIPS AND ACTIVITIES AS MAY BE DEEMED APPROPRIATE FOR THE GROWTH AND DEVELOPMENT OF MHCS IN ALBERT LEA AND SURROUNDING COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $279,449 | ExpenseAmt |
| Grant | $279,449 | GrantAmt |
| Desc | NAEVE HEALTH CARE FOUNDATION'S (NHCF) 2013 GIFT OF $279,449 WAS DIRECTED TOWARDS PROJECTS WITHIN MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA; $202,624 WAS TO BE PUT TOWARDS THE HOSPITAL NURSE CALL SYSTEM AND $1,000 TO SUPPORT PATIENT EDUCATION'S ANNUAL WOMEN'S HEALTH CARE SYMPOSIUM. $75,825 WAS RAISED BY THE NHCF GALA, WHICH WAS ALSO TO BE PUT TOWARDS THE HOSPITAL NURSE CALL SYSTEM. | Desc |
| Total Program Service Expenses | $279,449 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | 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 | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 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 | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | MARY A WOLESKY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5074341603 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 1ST DRIVE NW | AddressLine1 |
| City | AUSTIN | City |
| State | MN | State |
| ZIP Code | 55912 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| BENDA HEATHER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BROWNLOW STEVE | |||||||
| TREASURER/DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CLARK DIANE L | |||||||
| SECRETARY/DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| ECKSTROM MD MICHAEL T | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ERLANDSON KENT | |||||||
| DIRECTOR (1/1-1/25/13) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JOHNSTON ALEX | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KALIS HENRY | |||||||
| DIRECTOR (1/1-1/25/13) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KOLKER DAN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LOCH SUE | |||||||
| VICE PRESIDENT (1/25-12/31/13)/DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MUELLER RICHARD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MURRAY RICHARD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MYERS MD THEODORE P | |||||||
| PRESIDENT (1/1-1/25/13)/DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| PULLEY BARB | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RASK MD CLIFFORD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SKOPHAMMER NANCY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| THOFSON ARLENE | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| VERMEDAHL CLAIRE | |||||||
| PRES (1/25-12/31/13)/VICE-PRES (1/1-1/25/13)/DIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BONNERUP DAVID R | |||||||
| EXECUTIVE DIRECTOR | 10.00 | 0.00 | $54,095 | $0 | $12,437 | Yes (X) | |
| CIOTA MD MARK R | |||||||
| EX-OFFICIO OFFICER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $54,095 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $12,437 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $62,595 | FundraisingAmt |
| All Other Contributions | $126,139 | AllOtherContributionsAmt |
| Total Contributions | $188,734 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $162,737 | TotalRevenueColumnAmt |
| Exclusion | $162,737 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,644,588 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,479,996 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $164,592 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $164,592 | TotalRevenueColumnAmt |
| Exclusion | $164,592 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $13,230 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $62,595 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,230 | TotalRevenueColumnAmt |
| Exclusion | $13,230 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $529,293 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $340,559 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,449 | TotalAmt |
| Program Services | $279,449 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,032 | TotalAmt |
| Management And General | $35,032 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,481 | TotalAmt |
| Program Services | $279,449 | ProgramServicesAmt |
| Management And General | $35,032 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,700 | BOYAmt |
| EOY | $1,644 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $49 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,465,536 | BOYAmt |
| EOY | $4,937,089 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,915 | BOYAmt |
| EOY | $10,026 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,509,151 | BOYAmt |
| EOY | $4,948,808 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,150,948 | BOYAmt |
| EOY | $4,548,154 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,660 | BOYAmt |
| EOY | $119,111 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $281,543 | BOYAmt |
| EOY | $281,543 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,509,151 | BOYAmt |
| EOY | $4,948,808 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,509,151 | BOYAmt |
| EOY | $4,948,808 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $214,812 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $225,428 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$583 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $61,465 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $201,110 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $147,203 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $61,858 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $188,734 | CurrentTaxYearAmt |
| Total | $660,370 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $61,465 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $201,110 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $147,203 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $61,858 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $188,734 | CurrentTaxYearAmt |
| Total | $660,370 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $89,399 | SubstantialContributorsTotAmt |
| Public Support Total170 | $570,971 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $144,279 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $117,588 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $128,359 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $139,536 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $162,737 | CurrentTaxYearAmt |
| Total | $692,499 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,352,869 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $28,700 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.42200 | PublicSupportCY170Pct |
| Public Support PY170 | 0.45970 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $281,543 | BeginningYearBalanceAmt |
| End Year Balance | $281,543 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $301,543 | BeginningYearBalanceAmt |
| Grants Or Scholarships | $20,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $281,543 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $301,543 | BeginningYearBalanceAmt |
| End Year Balance | $301,543 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $301,543 | BeginningYearBalanceAmt |
| End Year Balance | $301,543 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $281,543 | BeginningYearBalanceAmt |
| Contributions | $20,000 | ContributionsAmt |
| End Year Balance | $301,543 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | WELLS FARGO INVESTMENTS | Desc |
| Book Value | $4,937,089 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $4,937,089 | TotalBookValueSecuritiesAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | TO SUPPORT PATIENTS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp (9 entries)
| RegionRegionTxt | OfficesOfficesCnt | EmployeeEmployeeCnt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Region Total ExpendituresRegionTotalExpendituresAmt |
|---|---|---|---|---|
| EAST ASIA AND THE PACIFIC - AUSTRALIA, BRUNEI, BURMA, CAMBODIA, | 0 | 0 | INVESTMENT | $280,893 |
| EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM | 0 | 0 | INVESTMENT | $380,675 |
| MIDDLE EAST AND NORTH AFRICA - ALGERIA, BAHRAIN, DJIBOUTI, EGYPT, | 0 | 0 | INVESTMENT | $19,263 |
| NORTH AMERICA - CANADA AND MEXICO, BUT BUT NOT THE UNITED STATES | 0 | 0 | INVESTMENT | $235,751 |
| RUSSIA & THE NEWLY INDEPENDENT STATES - ARMENIA, AZERBIJAN, BELARUS, | 0 | 0 | INVESTMENT | $50,725 |
| SOUTH AMERICA - ARGENTINA, BOLIVIA, BRAZIL, CHILE, COLUMBIA, ECUADOR, | 0 | 0 | INVESTMENT | $47,872 |
| SOUTH ASIA - AFGHANISTAN, BANGLADESH, BHUTAN, INDIA, MALDIVES, NEPAL, | 0 | 0 | INVESTMENT | $46,294 |
| SUB-SAHARAN AFRICA - ANGOLA, BENIN, BOTSWANA, BURKINA, FASO, | 0 | 0 | INVESTMENT | $44,167 |
| CENTRAL AMERICA AND THE CARIBBEAN | 0 | 0 | INVESTMENT | $30,442 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $1,105,640 | SubtotalSpentAmt |
| Continuation Spent | $30,442 | ContinuationSpentAmt |
| Total Spent | $1,136,082 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1Amt |
| Gross Receipts Event1 | $75,825 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $62,595 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $13,230 | GrossRevenueEvent1Amt |
| Gross Receipts Total | $75,825 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $62,595 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $13,230 | GrossRevenueTotalEventsAmt |
| Net Income Summary | $13,230 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM-ALBERT LEA AND AUSTIN | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 404 FOUNTAIN ST | AddressLine1 |
| City | ALBERT LEA | City |
| State | MN | State |
| ZIP Code | 56007 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 411404075 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $279,449 | CashGrantAmt |
| Purpose Of Grant | SUPPORT PROGRAMS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS ARE USED TO SUPPORT THE OPERATIONS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. GRANTS CAN ONLY BE USED FOR THE INTENDED PURPOSE. NO ADDITIONAL MONITORING IS PERFORMED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II COMPENSATION FROM AN UNRELATED ORGANIZATION | FormAndLineReferenceDesc |
| Explanation | DAVE BONNERUP IS EMPLOYED BY AND RECEIVES COMPENSATION FROM MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN, HOWEVER, A PORTION OF THE COMPENSATION REPORTED IN CORE FORM 990, PART VII, WHICH INCLUDES BASE AND DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS, IS FOR SERVING AS THE EXECUTIVE DIRECTOR OF NAEVE HEALTH CARE FOUNDATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | MARK R. CIOTA, M.D. AND MICHAEL T. ECKSTROM ARE OFFICERS, DIRECTORS, OR TRUSTEES OF AN ORGANIZATION WHICH RESULTS IN A BUSINESS RELATIONSHIP WITH DAVID R. BONNERUP, MARK R. CIOTA, M.D., DIANE L. CLARK, AND MICHAEL T. ECKSTOM, M.D. WHO ARE EMPLOYEES OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE DEVELOPMENT OFFICER OF THE REPORTING ORGANIZATION IS AN EMPLOYEE OF MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY MAYO CLINIC CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE DEVELOPMENT OFFICER AND SITE FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | IN ACCORDANCE WITH THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, THE FOLLOWING INDIVIDUALS ARE REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST ACKNOWLEDGEMENT: - BOARD OF TRUSTEE MEMBERS - MEMBERS OF THE MAJOR NAEVE HEALTH CARE FOUNDATION COMMITTEES - EMPLOYEES AND/OR THE DEVELOPMENT OFFICER OF NAEVE HEALTH CARE FOUNDATION ANY INDIVIDUAL FROM THE ABOVE GROUPS MAY BE ASKED TO ABSTAIN FROM VOTING OR PARTICIPATING IN THE DECISION MAKING ACTIVITIES AFFECTED BY THE CONFLICT OF INTEREST DISCLOSURE. AN INDIVIDUAL MAY BE ASKED TO LEAVE A MEETING WHERE THE DECISION MAKING ACTIVITIES WOULD BE AFFECTED BY THE CONFLICT OF INTEREST DISCLOSURE. IF AN INDIVIDUAL NEGLECTS TO DISCLOSE APPROPRIATELY, DISCIPLINARY ACTION WILL BE CONSIDERED UP TO AND INCLUDING TERMINATION OF EMPLOYMENT AND/OR POSITION ON THE FOUNDATION BOARD. THE COMPLIANCE OFFICER OF MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN ASSISTS THE BOARD IN DISTRIBUTION AND COLLECTION OF ANNUAL CONFLICT OF INTEREST DISCLOSURE FORMS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FILING ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | PLEDGE WRITE-OFF -583. |
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