2014-08-29T14:00:19-05:00 2013-12-31 990 2013-01-01 411989509 NAEVE HEALTH CARE FOUNDATION NAEV 5073776380 404 WEST FOUNTAIN ST ALBERT LEA MN 56007 CLAIRE VERMEDAHL PRESIDENT 5073776380 2014-08-29 2013 2015-11-30 17:44:51Z CLAIRE VERMEDAHL 404 WEST FOUNTAIN ST ALBERT LEA MN 56007 3009289 0 X HTTP:WWW.NAEVEFOUNDATION.COM X 2000 MN RAISING PHILANTHROPIC DOLLARS FOR HIGH QUALITY COST-EFFECTIVE HEALTHCARE AT MCHS IN ALBERT LEA. 15 15 0 25 0 0 61858 188734 0 0 185057 327329 0 13230 246915 529293 329398 279449 0 0 0 0 0 0 0 31676 35032 361074 314481 -114159 214812 4509151 4948808 0 0 4509151 4948808 X 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. 0 0 279449 279449 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. 279449 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 15 15 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X MARY A WOLESKY 5074341603 1000 1ST DRIVE NW AUSTIN MN 55912 BENDA HEATHER DIRECTOR 1.00 0.00 X 0 0 0 BROWNLOW STEVE TREASURER/DIRECTOR 1.00 0.00 X X 0 0 0 CLARK DIANE L SECRETARY/DIRECTOR 1.00 0.00 X X 0 0 0 ECKSTROM MD MICHAEL T DIRECTOR 1.00 0.00 X 0 0 0 ERLANDSON KENT DIRECTOR (1/1-1/25/13) 1.00 0.00 X 0 0 0 JOHNSTON ALEX DIRECTOR 1.00 0.00 X 0 0 0 KALIS HENRY DIRECTOR (1/1-1/25/13) 1.00 0.00 X 0 0 0 KOLKER DAN DIRECTOR 1.00 0.00 X 0 0 0 LOCH SUE VICE PRESIDENT (1/25-12/31/13)/DIRECTOR 1.00 0.00 X X 0 0 0 MUELLER RICHARD DIRECTOR 1.00 0.00 X 0 0 0 MURRAY RICHARD DIRECTOR 1.00 0.00 X 0 0 0 MYERS MD THEODORE P PRESIDENT (1/1-1/25/13)/DIRECTOR 1.00 0.00 X X 0 0 0 PULLEY BARB DIRECTOR 1.00 0.00 X 0 0 0 RASK MD CLIFFORD DIRECTOR 1.00 0.00 X 0 0 0 SKOPHAMMER NANCY DIRECTOR 1.00 0.00 X 0 0 0 THOFSON ARLENE DIRECTOR 1.00 0.00 X 0 0 0 VERMEDAHL CLAIRE PRES (1/25-12/31/13)/VICE-PRES (1/1-1/25/13)/DIR 1.00 0.00 X X 0 0 0 BONNERUP DAVID R EXECUTIVE DIRECTOR 10.00 0.00 X 54095 0 12437 CIOTA MD MARK R EX-OFFICIO OFFICER 1.00 0.00 X 0 0 0 54095 0 12437 0 0 0 1 0 62595 126139 188734 162737 162737 2644588 2479996 164592 164592 164592 13230 62595 0 13230 13230 529293 0 0 340559 279449 279449 35032 35032 314481 279449 35032 0 23700 1644 0 49 4465536 4937089 19915 10026 4509151 4948808 0 0 X 4150948 4548154 76660 119111 281543 281543 4509151 4948808 4509151 4948808 X 214812 225428 -583 X 0 0 0 X 61465 201110 147203 61858 188734 660370 61465 201110 147203 61858 188734 660370 89399 570971 144279 117588 128359 139536 162737 692499 1352869 28700 0.42200 0.45970 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 281543 281543 301543 20000 281543 301543 301543 301543 301543 281543 20000 301543 1.00000 0 0 0 WELLS FARGO INVESTMENTS 4937089 F 4937089 PART V, LINE 4: TO SUPPORT PATIENTS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. EAST ASIA AND THE PACIFIC - AUSTRALIA, BRUNEI, BURMA, CAMBODIA, 0 0 INVESTMENT 280893 EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 0 0 INVESTMENT 380675 MIDDLE EAST AND NORTH AFRICA - ALGERIA, BAHRAIN, DJIBOUTI, EGYPT, 0 0 INVESTMENT 19263 NORTH AMERICA - CANADA AND MEXICO, BUT BUT NOT THE UNITED STATES 0 0 INVESTMENT 235751 RUSSIA & THE NEWLY INDEPENDENT STATES - ARMENIA, AZERBIJAN, BELARUS, 0 0 INVESTMENT 50725 SOUTH AMERICA - ARGENTINA, BOLIVIA, BRAZIL, CHILE, COLUMBIA, ECUADOR, 0 0 INVESTMENT 47872 SOUTH ASIA - AFGHANISTAN, BANGLADESH, BHUTAN, INDIA, MALDIVES, NEPAL, 0 0 INVESTMENT 46294 SUB-SAHARAN AFRICA - ANGOLA, BENIN, BOTSWANA, BURKINA, FASO, 0 0 INVESTMENT 44167 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 30442 0 0 0 0 0 0 1105640 30442 1136082 0 0 0 0 0 0 GALA 75825 62595 13230 75825 62595 13230 13230 1 MAYO CLINIC HEALTH SYSTEM-ALBERT LEA AND AUSTIN 404 FOUNTAIN ST ALBERT LEA MN 56007 411404075 501(C)(3) 279449 SUPPORT PROGRAMS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. 1 0 PART I, LINE 2: 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. 0 0 0 0 0 0 0 0 0 PART II COMPENSATION FROM AN UNRELATED ORGANIZATION 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. 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.