LAKE REGION HEALTHCARE FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LAKE REGION HEALTHCARE FOUNDATION (EIN 41-1677288)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-05-14
- IRS object ID
- 201311359349301166
- Schema version
- 2011v1.2
- 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 G
- Schedule I
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T16:39:38-07:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411677288 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE REGION HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAKE | NameControl |
| Phone | 2187368000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 712 S CASCADE ST | AddressLine1 |
| City | FERGUS FALLS | City |
| State | MN | State |
| ZIP Code | 565380728 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRETT LONGTIN CPA | Name |
| Title | SR VP/CFO | Title |
| Phone | 2187368000 | Phone |
| Date Signed | 2013-04-18 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Larry Dorn | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 712 S Cascade St | AddressLine1 |
| City | Fergus Falls | City |
| State | MN | State |
| ZIP Code | 56537 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1286603 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Type Of Org Other Description | Foundation | TypeOfOrgOtherDescription |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | THE PURPOSE OF THE LAKE REGION HOSPITAL FOUNDATION IS TO RECEIVE GIFTS AND DONATIONS TO HELP LAKE REGION HOSPITAL FULFILL IT'S MISSION OF PROVIDING QUALITY HEALTHCARE SERVICES IN A CARING MANNER TO EVERY INDIVIDUAL WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 186 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1476063 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 714670 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 135333 | InvestmentIncomePriorYear |
| Investment Income Current Year | 292378 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 22699 | OtherRevenuePriorYear |
| Other Revenue Current Year | 19489 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1634095 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1026537 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 5718 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 43463 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2363 | OtherExpensePriorYear |
| Other Expenses Current Year | 136930 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8081 | TotalExpensesPriorYear |
| Total Expenses Current Year | 180393 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1626014 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 846144 | RevenuesLessExpensesCY |
| Total Assets BOY | 8970249 | TotalAssetsBOY |
| Total Assets EOY | 10343272 | TotalAssetsEOY |
| Total Liabilities BOY | 6419 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 12507 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8963830 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10330765 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PURPOSE OF THE LAKE REGION HOSPITAL FOUNDATION IS TO RECEIVE GIFTS AND DONATIONS TO HELP LAKE REGION HOSPITAL FULFILL IT'S MISSION OF PROVIDING QUALITY HEALTHCARE SERVICES IN A CARING MANNER TO EVERY INDIVIDUAL WE SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 180393 | Expense |
| Grants | 43463 | Grants |
| Revenue | 365049 | Revenue |
| Description | LAKE REGION HOSPITAL FOUNDATION RECEIVED DONATIONS AND MEMORIALS FROM SEVERAL INDIVIDUALS AND BUSINESSES. IT ALSO RECEIVES PLEDGES AND PAYMENTS OF THOSE PLEDGES. THE FOUNDATION USES SOME OF IT'S FUNDS FOR A VARIETY OF PURPOSES WHICH AID LAKE REGION HEALTHCARE AND THE COMMUNITY IN PROVIDING QUALITY HEALTHCARE. | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 180393 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 1 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 0 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE REGION HEALTHCARE CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2187368000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 712 S CASCADE ST | AddressLine1 |
| Address Line2 | PO BOX 728 | AddressLine2 |
| City | FERGUS FALLS | City |
| State | MN | State |
| ZIP Code | 565380728 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| LARRY DORN | |||||
| CHAIRMAN | 2 | X | 0 | 0 | 0 |
| SOLVEIG HALBAKKEN | |||||
| VICE CHAIR | 2 | X | 0 | 0 | 0 |
| DENNIS EMMEN | |||||
| SECRETARY/TREASURER | 2 | X | 0 | 0 | 0 |
| DAVID JOHNSON | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| STEPHEN RUFER | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| LESLIE SYVERSON MD | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| GARY SPIES | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| MARY LAMPY VELO | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| DAVID BJORK MD | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| PAUL ETZELL MD | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| LINDA MATTER PHD | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| DAVE BICKETT | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| TODD MCGOVERN DDS | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| DIC PICKET CPA | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| CRYSTAL ADAMS | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| KATHY BURGAU | |||||
| TRUSTEE | 2 | X | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 0 | GovernmentGrants |
| All Other Contributions | 714670 | AllOtherContributions |
| Noncash Contributions | 310959 | NoncashContributions |
| Total Contributions | 714670 | TotalContributions |
| Total Program Service Revenue | 0 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 286438 | TotalRevenueColumn |
| Related Or Exempt Function Income | 286438 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 212824 | Securities |
| Other | 0 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 206884 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5940 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5940 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5940 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 65903 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 39912 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25991 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $25,991 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 0 | GrossIncomeGaming |
| Gaming Direct Expenses | 0 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 6768 | GrossSalesOfInventory |
| Cost Of Goods Sold | 13270 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -6502 | TotalRevenueColumn |
| Related Or Exempt Function Income | -6502 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1026537 | TotalRevenueColumn |
| Related Or Exempt Function Income | 285876 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $25,991 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43463 | Total |
| Program Services | 43463 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| MISCELLANEOUS EXPENSE | 9039 | 9039 | 0 | 0 |
| SERVICE CHARGES | 45 | 45 | 0 | 0 |
| MEALS & MEETING EXPENSE | 1657 | 1657 | 0 | 0 |
| BAD DEBTS | 126189 | 126189 | 0 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 180393 | Total |
| Program Services | 180393 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 944315 | BOY |
| EOY | 1536265 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2288517 | BOY |
| EOY | 1327253 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5737417 | BOY |
| EOY | 7479754 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8970249 | BOY |
| EOY | 10343272 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6419 | BOY |
| EOY | 12507 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6419 | BOY |
| EOY | 12507 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8963830 | BOY |
| EOY | 10330765 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8963830 | BOY |
| EOY | 10330765 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8970249 | BOY |
| EOY | 10343272 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 846144 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 520791 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Contrib By Controlling Individual | 1 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE REGION HEALTHCARE CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410730602 | EIN |
| Type Of Organization | 170(b)(1)(A)(iii) | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $52,191 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 52191 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number DA Fs Held | 10277 | NumberDAFsHeld |
| Number Funds Held | 0 | NumberFundsHeld |
| Donor Advised Contributions | 254 | DonorAdvisedContributions |
| Contrib To Funds And Other Accounts | 0 | ContribToFundsAndOtherAccounts |
| Grants Paid From Donor Funds | 812 | GrantsPaidFromDonorFunds |
| Grants Funds And Other Accounts | 0 | GrantsFundsAndOtherAccounts |
| Aggregate DAF Value | 9719 | AggregateDAFValue |
| Aggregate Fund Value | 0 | AggregateFundValue |
| Disclosed Orgs Legal Control | 1 | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | 1 | DisclosedForCharitablePurposes |
| Total Revenue | 1026537 | TotalRevenue |
| Total Expenses | 180393 | TotalExpenses |
| Excess Or Deficit For Year | 846144 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 573483 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 0 | DonatedServicesAndFacilities |
| Investment Expenses | 0 | InvestmentExpenses |
| Prior Period Adjustments | 0 | PriorPeriodAdjustments |
| Other | -$52,691 | OtherAmount |
| Total Adjustments | 520792 | TotalAdjustments |
| Excess Or Deficit Per FS | 1366936 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 715287 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 0 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 715287 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 311250 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 311250 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1026537 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 256419 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 76026 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 76026 | ExpensesNotRptdF990 |
| Expenses Subtotal | 180393 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 180393 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchD_P11_S00_L08 | Schedule D, Part XI, Line 8 | THERE WAS A TOTAL OF $(52,691) OF RELATED COMPANY TRANSFERS FOR THE LAKE REGION HOSPITAL FOUNDATION. |
| SchD_P12_S00_L04b | Schedule D, Part XII, Line 4b | THERE WAS A TOTAL OF CONTRIBUTIONS OF $275,747, PRESENT VALUE AND PLEDGE ALLOWANCE ADJUSTMENT OF $86,837, FUNDRAISING EXPENSE $(39,912), COST OF GOODS SOLD $(13,270), AND INVESTMENT INCOME OF $1,850. |
| SchD_P13_S00_L02d | Schedule D, Part XIII, Line 2d | THERE WAS A TOTAL OF ADDITIONAL RELATED PARTY TRANSFERS OF $22,844, COST OF GOODS SOLD OF $13,270 AND $39,912 OF FUNDRAISING EXPENSE. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | PRCA RODEO | NameOfEvent1 |
| Gross Receipts Event1 | 22140 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 0 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 22140 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 0 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 0 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 0 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 0 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 0 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 5861 | OtherDirectExpensesEvent1 |
| Name Of Event2 | ROCK & ROLL REVUE | NameOfEvent2 |
| Gross Receipts Event2 | 31190 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 0 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 31190 | GrossRevenueEvent2 |
| Cash Prizes Event2 | 0 | CashPrizesEvent2 |
| Non Cash Prizes Event2 | 0 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 0 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 0 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 0 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 24551 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 5 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 12572 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 0 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 12572 | GrossRevenueOtherEvents |
| Cash Prizes Other Events | 0 | CashPrizesOtherEvents |
| Non Cash Prizes Other Events | 0 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 0 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 0 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 0 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 9500 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 65902 | GrossReceiptsTotal |
| Charitable Contributions Total | 0 | CharitableContributionsTotal |
| Gross Revenue Total Events | 65902 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 0 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 0 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 0 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 0 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 0 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 39912 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 39912 | DirectExpenseSummaryEvents |
| Net Income Summary | 25990 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchI_P01_S00_L02 | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | GRANTS AWARDED BY THE LAKE REGION HOSPITAL FOUNDATION HAVE TO MEET CERTAIN GUIDELINES WHICH INCLUDE (1) REQUESTS MUST BE FOR HEALTH-RELATED PROGRAMS OR PROJECTS, AND MUST BENEFIT INDIVIDUALS LIVING WITHIN THE LRHC SERVICE AREA (2) NO REQUESTS WILL BE ACCEPTED ON BEHALF OF AN INDIVIDUAL OR A FAMILY (3) NO GRANTS WILL BE MADE TO INSTITUTIONS WHICH IN POLICY OR PRACTICE DISCRIMINATE ON THE BASIS OF RACE, CREED, GENDER, OR SEXUAL ORIENTATION (4) ANY PUBLISHED ARTICLES, PRESS RELEASES, OR INFORMATION RELATED TO THE GRANT RELEASED BY YOUR ORGANIZATION SHOULD STATE THAT THE PROJECT WAS FULLY OR PARTIALLY FUNDED BY DONATIONS TO THE LAKE REGION HOSPITAL FOUNDATION (5) FUNDS AWARDED MUST BE EXPENDED ONLY FOR THE STATED PURPOSE ON THE APPLICATION (6) FUNDS MUST BE DISTRIBUTED WITHIN ONE CALENDAR YEAR OF THE AWARD AND (7) DISBURSEMENTS MAY BE DISCONTINUED IF THE PROGRAM OR PROJECT IS DISCONTINUED, OR ITS ORIGINAL PURPOSE ALTERED. | Explanation |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTraded
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 7 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 310959 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Market Value | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0A_L06 | Form 990, Part VI, Section A, Line 6 | LAKE REGION HEALTHCARE CORPORATION IS A SOLE MEMBER. |
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | COPIES OF THE COMPLETED 990, WITH SUPPORTING SCHEDULES AND FOOTNOTES, WILL BE DISTRIBUTED TO ALL THE FOUNDATION BOARD MEMEBERS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE DETAILED AND CONSCIENTIOUS REVIEW BY ALL BOARD MEMBERS, CHIEF EXECUITVE OFFICER, AND CHIEF FINANCIAL OFFICER TO ENABLE AN OPPORTUNITY FOR FEEDBACK AND CORRECTION. ALL QUESTIONS, CONCERNS, OR OTHER FEEDBACK FROM BOARD MEMBERS WILL BE DIRECTED TO THE LRHC CHIEF FINANCIAL OFFICER AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | OFFICERS AND TRUSTEES ANNUALLY ASSESS WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST ACCORDING TO THE CONFLICTS OF INTERST POLICY. IT IS CONSISTANTLY MONITORED DURING THE YEAR TO BE SURE THAT THE POLICY IS BEING FOLLOWED. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| F990_P09_S00_L24a | Form 990, Part IX, Line 24a - 24e | THE BAD DEBT EXPENSE OF $126,189 WAS DUE TO WRITING OFF PLEDGES THAT LAKE REGION HOSPITAL FOUNDATION DEEMED UNCOLLECTIBLE. |
| F990_P11_S00_L05 | Form 990, Part XI, Line 5 | THERE WAS A TOTAL OF $520,792 OF RELATED COMPANY TRANSFERS AND UNREALIZED GAINS ON INVESTMENTS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | Address Line2AddressUS/AddressLine2 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKE REGION HEALTHCARE CORPORATION | |||||||||||
| 712 S CASCADE ST | PO BOX 728 | FERGUS FALLS | MN | 565380728 | 410730602 | HOSPITAL | MN | 501(C)(3) | N/A | 0 | |
| LRHC LONG TERM CARE FACILITIES INC | |||||||||||
| 712 S CASCADE ST | PO BOX 728 | FERGUS FALLS | MN | 565380728 | 411817549 | ASSISTED LIVING | MN | 501(C)(3) | 0 | LAKE REGION HEALTHCARE CORPORATION | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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