CHISHOLM HEALTH CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: CHISHOLM HEALTH CENTER (EIN 41-1879639)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-02-13
IRS object ID: 201440449349301869
Schema version: 2012v2.3
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 D
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-02-13T15:26:44-06:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CONWAY DEUTH & SCHMIESING PLLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	401 ATLANTIC AVE	AddressLine1
City	MORRIS	City
State	MN	State
ZIP Code	562671324	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	411879639	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CHISHOLM HEALTH CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CHIS	NameControl
Phone	2182545765	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	321 NE 6TH STREET	AddressLine1
City	CHISHOLM	City
State	MN	State
ZIP Code	55719	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	LUVERNE HOFFMAN	Name
Title	PRESIDENT	Title
Phone	2182545765	Phone
Date Signed	2014-02-09	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JAMES A GILMAN CPA	Name
Phone	3205892602	Phone
Date Prepared	2014-02-09	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	LUVERNE HOFFMAN	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	801 NEVADA AVE	AddressLine1
City	MORRIS	City
State	MN	State
ZIP Code	56267	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	5876970	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.SFHS.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1997	YearFormation
State Legal Domicile	MN	StateLegalDomicile
Activity Or Mission Description	WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES CHISHOLM HEALTH CENTER AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE AGREE TO PROMOTE THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	13	NbrIndependentVotingMembers
Total Nbr Employees	158	TotalNbrEmployees
Total Nbr Volunteers	22	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	2919	ContributionsGrantsPriorYear
Contributions Grants Current Year	2045	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	6151072	ProgramServiceRevenuePriorYear
Program Service Revenue CY	5848709	ProgramServiceRevenueCY
Investment Income Prior Year	398	InvestmentIncomePriorYear
Investment Income Current Year	592	InvestmentIncomeCurrentYear
Other Revenue Prior Year	27454	OtherRevenuePriorYear
Other Revenue Current Year	24398	OtherRevenueCurrentYear
Total Revenue Prior Year	6181843	TotalRevenuePriorYear
Total Revenue Current Year	5875744	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	3489153	SalariesEtcPriorYear
Salaries Etc Current Year	3384891	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	2116578	OtherExpensePriorYear
Other Expenses Current Year	2071540	OtherExpensesCurrentYear
Total Expenses Prior Year	5605731	TotalExpensesPriorYear
Total Expenses Current Year	5456431	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	576112	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	419313	RevenuesLessExpensesCY
Total Assets BOY	6504056	TotalAssetsBOY
Total Assets EOY	6273614	TotalAssetsEOY
Total Liabilities BOY	4528529	TotalLiabilitiesBOY
Total Liabilities EOY	4978774	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1975527	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1294840	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES CHISHOLM HEALTH CENTER AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE AGREE TO PROMOTE THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	4913655	Expense
Revenue	5875744	Revenue
Description	CHISHOLM HEALTH CENTER IS A 78 BED SKILLED NURSING FACILITY LOCATED IN RURAL MINNESOTA. THE FACILITY PROVIDES MEDICAL, SOCIAL, AND SPIRITUAL CARE TO ITS RESIDENTS WITHOUT REGARD TO RACE, COLOR, CREED, OR NATIONAL ORIGIN, IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT STATUS. DURING THE CURRENT REPORTING YEAR, THE ORGANIZATION HAD 27,367 PATIENT DAYS AND PROVIDED SERVICES TO MORE THAN 189 PATIENTS. ALSO DURING THIS TIME PERIOD, THE ORGANIZATION EMPLOYED ABOUT 87 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 3.0 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE VERY LIMITED.	Description
Total Program Service Expense	4913655	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	true	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	15	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	158	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	13	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	true	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	MN	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	SHERRY WAGNER	NamePerson
Telephone Number	3205894919	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	801 NEVADA AVENUE	AddressLine1
City	MORRIS	City
State	MN	State
ZIP Code	56267	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Highest Compensated EmployeeHighestCompensatedEmployee
DON GIESELMANN
CHAIR	1.00	X	X	0	0	0
VIVIAN HELTEMES
TRUSTEE - ST	1.00	X		0	0	0
STEVE LIENEMANN
TRUSTEE	1.00	X		0	0	0
KATIE ERDMAN
TRUSTEE	1.00	X		0	0	0
MAGGIE FLETCHER
TRUSTEE	1.00	X		0	0	0
BARBARA SPAULDING
TRUSTEE	1.00	X		0	0	0
DOUGLAS WARTNER
TRUSTEE	1.00	X		0	0	0
ANDY LOPEZ
VICE CHAIR	1.00	X	X	0	0	0
KENNY WESTBROCK
TRUSTEE - DO	1.00	X		0	0	0
KEN KELLER
TRUSTEE	1.00	X		0	0	0
RANDY SUTTER
SEC/TREASURE	1.00	X	X	0	0	0
FATHER ROBERT KIEFFER
TRUSTEE	1.00	X		0	0	0
ROSE MURPHY
TRUSTEE	1.00	X		0	0	0
NEIL SCHMIDGALL
TRUSTEE		X		0	0	0
LUVERNE HOFFMAN
PRES/CEO	1.00		X	0	352011	44716	39.00
CAROL RAW
VP SENIOR SV			X	0	131574	17328	40.00
SHERRY WAGNER
CFO	1.00		X	0	101964	6040	39.00
DENNIS LINDOR
VP BEHAV SVC			X	0	81155	20832	40.00
GEOFFREY RYAN
ADMIN - CHC	40.00			0	116061	5770		X
SCOTT JACKSON
DIRECTOR OF				0	104821	12646	40.00	X

Field	Value	IRS element (for citing)
Total Reportable Comp Frm Rltd Orgs	887586	TotalReportableCompFrmRltdOrgs
Total Other Compensation	107332	TotalOtherCompensation
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ST FRANCIS HEALTH SERVICES
801 NEVADA AVE	MORRIS	MN	56267	MANAGEMENT FEES	443717
JOHNSON WILSON CONTRACTORS INC
PO BOX 16006	DULUTH	MN	55816	CONSTRUCTION	433355

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K
All Other Contributions	2045	AllOtherContributions
Total Contributions	2045	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	NET RESIDENT SERVICE REVENUE	Description
Total Revenue Column	5848709	TotalRevenueColumn
Related Or Exempt Function Income	5848709	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	5848709	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	592	TotalRevenueColumn
Exclusion	$592	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	2066	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	1226	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	840	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
APARTMENT RENTAL	14138	14138
GUEST, EMPLOYEE & APT MEALS	6923	6923
MISCELLANEOUS	2497	2497

Field	Value	IRS element (for citing)
Total Other Revenue	23558	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	5875744	TotalRevenueColumn
Related Or Exempt Function Income	5872267	RelatedOrExemptFunctionIncome
Exclusion	$592	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	2769487	Total
Program Services	2720201	ProgramServices
Management And General	49286	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	85943	Total
Program Services	84414	ProgramServices
Management And General	1529	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	315043	Total
Program Services	310082	ProgramServices
Management And General	4961	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	214418	Total
Program Services	210602	ProgramServices
Management And General	3816	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	358800	Total
Management And General	358800	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	66	Total
Management And General	66	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	6355	Total
Management And General	6355	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	11934	Total
Management And General	11934	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	19679	Total
Management And General	19679	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	155455	Total
Program Services	155455	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	2369	Total
Management And General	2369	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	2686	Total
Management And General	2686	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	179004	Total
Program Services	179004	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	289900	Total
Program Services	289900	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	38447	Total
Management And General	38447	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
SUPPLIES	357787	357787
MEDICAL SURCHARGE	239275	239275
MEDICAL PROF. FEES	169576	169576
CONSULTING	76162	76162

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	164045	Total
Program Services	121197	ProgramServices
Management And General	42848	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	5456431	Total
Program Services	4913655	ProgramServices
Management And General	542776	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	581062	BOY
EOY	739627	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	719698	BOY
EOY	544190	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	36409	BOY
EOY	21094	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	8270703	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	3399137	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	5060553	BOY
EOY	4871566	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	106334	BOY
EOY	97137	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	6504056	BOY
EOY	6273614	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	484313	BOY
EOY	410370	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	3984365	BOY
EOY	2251419	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	9542	BOY
EOY	11756	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
EOY	2305229	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	50309	BOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	4528529	BOY
EOY	4978774	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1975527	BOY
EOY	1294840	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1975527	BOY
EOY	1294840	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	6504056	BOY
EOY	6273614	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	419313	ReconcilationRevenueExpenses
Reconcilation Other Changes	-1100000	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	2198	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2919	CurrentTaxYearMinus1Year
Current Tax Year	2045	CurrentTaxYear
Total	7162	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6600929	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6675129	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6491058	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6179759	CurrentTaxYearMinus1Year
Current Tax Year	5874333	CurrentTaxYear
Total	31821208	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6600929	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6675129	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6493256	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6182678	CurrentTaxYearMinus1Year
Current Tax Year	5876378	CurrentTaxYear
Total	31828370	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	163875	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	353316	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	290457	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	478975	CurrentTaxYearMinus1Year
Current Tax Year	600173	CurrentTaxYear
Total	1886796	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	163875	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	353316	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	290457	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	478975	CurrentTaxYearMinus1Year
Current Tax Year	600173	CurrentTaxYear
Total	1886796	Total

Field	Value	IRS element (for citing)
Public Support Total509	29941574	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4568	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2472	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	984	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	398	CurrentTaxYearMinus1Year
Current Tax Year	592	CurrentTaxYear
Total	9014	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4568	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2472	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	984	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	398	CurrentTaxYearMinus1Year
Current Tax Year	592	CurrentTaxYear
Total	9014	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6605497	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6677601	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6494240	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6183076	CurrentTaxYearMinus1Year
Current Tax Year	5876970	CurrentTaxYear
Total	31837384	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.94050	PublicSupportPercentage509
Prior Year Support Percentage	0.95080	PriorYearSupportPercentage
Investment Income Percentage	0.00000	InvestmentIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	true	AgentTrusteeEtc
Beginning Balance	9542	BeginningBalance
Additions During Year	33473	AdditionsDuringYear
Distributions During Year	31259	DistributionsDuringYear
Ending Balance	11756	EndingBalance
Included On FS	true	IncludedOnFS
Explanation In Part XIII	X	ExplanationInPartXIII

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	10000	OtherCostOrOtherBasis
Book Value	10000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	7774944	OtherCostOrOtherBasis
Depreciation	2980001	Depreciation
Book Value	4794943	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	458895	OtherCostOrOtherBasis
Depreciation	392272	Depreciation
Book Value	66623	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	26864	OtherCostOrOtherBasis
Depreciation	26864	Depreciation

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4871566	TotalOfBookValueLandBuildings

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
EXPLANATION FOR UNREPORTED CONTRIBUTIONS OR ASSETS	SCHEDULE D, PAGE 2, PART IV, LINE 1B	THE ORGANIZATION ACTS AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS.
ESCROW LIABILITY ARRANGEMENT EXPLANATION	SCHEDULE D, PAGE 2, PART IV, LINE 2B	THE ORGANIZATION ACTS AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Field	Value	IRS element (for citing)
Name Person	LUVERNE HOFFMAN	NamePerson
Title	PRESCEO	Title
Comp Based On Related Orgs	352011	CompBasedOnRelatedOrgs
Deferred Comp Related Orgs	27716	DeferredCompRelatedOrgs
Nontaxable Benefits Related Orgs	17000	NontaxableBenefitsRelatedOrgs
Total Compensation Related Orgs	396727	TotalCompensationRelatedOrgs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	BREMER BANK	BusinessNameLine1
Business Name Line2	HCF REV NOTE 2009A	BusinessNameLine2

Field	Value	IRS element (for citing)
Issuer EIN	416005047	IssuerEIN
Date Issued	2009-10-21	DateIssued
Issue Price	1143804	IssuePrice
Description Of Purpose	REFINANCING TAXABLE	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Current Refunding	false	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	false	FinalAllocationMade
Adequate Books And Recds Maintaind	false	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	false	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	false	MngmentCntrctBondFinancdPrprty
Any Research Agreements	false	AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test	false	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedProp
Remedial Action Taken	false	RemedialActionTaken
Non Qualified Bond Remed Procdrs	false	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiled
Rebate Not Due Yet	false	RebateNotDueYet
Exception To Rebate	false	ExceptionToRebate
No Rebate Due	false	NoRebateDue
Variable Rate Issue	false	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC
Gross Proceeds Invested	false	GrossProceedsInvested
Written Proc To Monitor Reqs	false	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	false	ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	PURPOSE OF ISSUE DESCRIPTION	Identifier
Return Reference	SCHEDULE K	ReturnReference
Explanation	BREMER BANK INDEBTEDNESS INCURRED TO FINANCE GENERAL REMODELING INFRASTRUCTURE IMPROVEMENTS AND WINDOW REPLACEMENT AT CHC	Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (10 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
MARK HOFFMAN
SON OF	45483	EMPLOYED IN	false
(no name)
LUVERNE HOFFMAN		MAINTENANCE	false
(no name)
PRES & CEO			false
ELIZABETH LETICH
DAUGHTER OF	77642	EMPLOYED AS AN	false
(no name)
CAROL RAW, VP		ADMINISTRATOR	false
ANDREW RAW
SON OF	32010	EMPLOYED IN	false
(no name)
CAROL RAW, VP		MAINTENANCE	false
DAWN FJORGE
WIFE OF DENNIS	71331	EMPLOYED AS RN/PD	false
(no name)
LINDOR VP OF			false
(no name)
BEHAVIOR SVC			false

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	ADDITIONAL INFORMATION	Identifier
Return Reference	SCHEDULE L PART V	ReturnReference
Explanation	DURING THE YEAR THE ORGANIZATION MAY EMPLOYEE INDIVIDUALS WHO MAY BE RELATED TO AN OFFICER DIRECTOR TRUSTEE OR KEY EMPLOYEE PAYMENTS FOR SERVICES WOULD BE MADE ACCORDING TO EMPLOYMENT POLICY AND DONE AT ARMS LENGTH DUE TO THE RURAL LOCATION OF THE ORGANIZATION AND THE NEED TO FIND QUALIFIED STAFF THESE EMPLOYMENT RELATIONSHIPS WOULD BE NECESSARY TO FURTHER THE ORGANIZATIONS EXEMPT PURPOSE	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990 - ORGANIZATION'S MISSION	WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES CHISHOLM HEALTH CENTER AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE AGREE TO PROMOTE THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES.
FIRST ACCOMPLISHMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4A	EMPLOYMENT OPPORTUNITIES ARE VERY LIMITED.
MANAGEMENT DELEGATED	FORM 990, PAGE 6, PART VI, LINE 3	ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION WITH COMMON CONTROL) MANAGES THE FACILITY.
CLASSES OF MEMBERS OR STOCKHOLDERS	FORM 990, PAGE 6, PART VI, LINE 6	THE ORGANIZATION IS ORGANIZED WITH MEMBERS. THE MEMBERS OF THE CORPORATION SHALL CONSIST OF THE BOARD OF DIRECTORS OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE CFO OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC REVIEWS THE TAX RETURN AS PART OF THE MANAGEMENT SERVICES.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY THE ORGANIZATION CONDUCTS IN-SERVICE TRAINING REVIEWING THE POLICY ON CONFLICTS OF INTEREST AND REQUIRES THE BOARD MEMBERS, MANAGEMENT STAFF, AND KEY EMPLOYEES TO DISCLOSE CONFLICTS.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR THE CEO - ANNUALLY THE HR DIRECTOR SUBMITS THE CEO'S JOB DESCRIPTION, PERFORMANCE EVALUATION FORM, ST. FRANCIS HEALTH SERVICES OF MORRIS, INC'S PAY GRADE SCHEDULE AND COMPARABLE WAGE SURVEY(S) TO THE CHAIRMAN OF THE BOARD. THE CHAIRMAN AND THE EVALUATION COMMITTEE OF THE BOARD REVIEWS THE PERFORMANCE AND DETERMINES THE SALARY OF THE CEO.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR OFFICERS - CEO AND THE HR DIRECTOR REVIEWS COMPARABLE WAGE SURVEY INFORMATION, REVIEWS PERFORMANCE (WITH INPUT FROM THE VP, IF APPROPRIATE) AND DETERMINES SALARY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON AN AS REQUESTED BASIS.
RELATED ORGANIZATIONS	FORM 990, PAGE 7, PART VII	ST. FRANCIS HEALTH SERVICES OF MORRIS, INC HAS A MANAGEMENT AGREEMENT WITH THE RELATED ENTITY.
OTHER CHANGES IN NET ASSETS EXPLANATION	FORM 990, PART XI, LINE 9	INTERCOMPANY TRANSFER 1,100,000

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
AITKIN HEALTH SERVICES
301 MINNESOTA AVENUE	AITKIN	MN	56431	203367397	CAREGIVER	MN	501C3	9	SFHS	false
BROWNS VALLEY HEALTH CENTER
RR 1 BOX 182D SOUTH JEFFERSON	BROWNS VALLEY	MN	56219	411668347	CAREGIVER	MN	501C3	9	SFHS	false
FRANCISCAN HEALTH CENTER
3910 MINNESOTA AVENUE	DULUTH	MN	55802	411799268	CAREGIVER	MN	501C3	9	SFHS	false
FARMINGTON HEALTH SERVICES
3410 23RD STREET W	FARMINGTON	MN	55024	200100365	CAREGIVER	MN	501C3	9	SFHS	false
GUARDIAN ANGELS HEALTH & REHAB CENT
1500 3RD AVENUE E	HIBBING	MN	55746	411810369	CAREGIVER	MN	501C3	9	SFHS	false
PRAIRIE COMMUNITY SERVICES
801 NEVADA AVENUE	MORRIS	MN	56267	411598442	CAREGIVER	MN	501C3	9	SFHS	false
PENNINGTON HEALTH SERVICES
130 LABREE AVENUE S	THIEF RIVER FALLS	MN	56701	205617275	CAREGIVER	MN	501C3	9	SFHS	false
RENVILLE HEALTH SERVICES
205 SE ELM AVENUE	RENVILLE	MN	56284	202581924	CAREGIVER	MN	501C3	9	SFHS	false
ST FRANCIS HEALTH SERVICES (SFHS)
801 NEVADA AVENUE	MORRIS	MN	56267	411484416	MGMT COMP	MN	501C3	9		false	N/A
VIEWCREST HEALTH CENTER
3111 CHURCH PLACE	DULUTH	MN	55811	411843283	CAREGIVER	MN	501C3	9	SFHS	false
WEST WIND VILLAGE
1001 SCOTT AVENUE	MORRIS	MN	56267	237625632	CAREGIVER	MN	501C3	9	SFHS	false
ZUMBROTA HEALTH SERVICES
433 MILL STREET	ZUMBROTA	MN	55992	510487275	CAREGIVER	MN	501C3	9	SFHS	false

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	true	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
ST FRANCIS HEALTH SERVICES OF MORR
M	358600	AMOUNT PAID OR ACCRUED
ST FRANCIS HEALTH SERVICES OF MORR
Q	1100000	AMOUNT PAID OR ACCRUED
ST FRANCIS HEALTH SERVICES OF MORR
E	2390647	AMOUNT BORROWED

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	ADDITIONAL INFORMATION	Identifier
Return Reference	SCHEDULE R	ReturnReference
Explanation	ST FRANCIS HEALTH SERVICES OF MORRIS INC HAS GUARANTEED EXISTING LOANS OF 2251419 AS SHOWN IN FORM 990 PART X LINE 20 THERE WERE NO NEW LOAN GUARANTEES DURING THE FISCAL YEAR ST FRANCIS HEALTH SERVICES OF MORRIS INC HAS ISSUED AN INTERCOMPANY LOAN AS SHOWN ON FORM 990 PART X LINE 24 THE ORGANIZATION HAS PAID 33669 IN INTEREST TO ST FRANCIS HEALTH SERVICES OF MORRIS INC DURING THE YEAR	Explanation