NAEVE HEALTH CARE FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- NAEVE HEALTH CARE FOUNDATION (EIN 41-1989509)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-05
- IRS object ID
- 201203109349301460
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-05T15:59:27-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411989509 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NAEVE HEALTH CARE FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NAEV | NameControl |
| Phone | 5073776380 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TP MYERS | Name |
| Title | PRESIDENT | Title |
| Phone | 5073776380 | Phone |
| Date Signed | 2012-11-05 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TP MYERS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 1541311 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://NAEVEFOUNDATION.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | RAISING PHILANTHROPIC DOLLARS FOR HIGH QUALITY COST-EFFECTIVE HEALTHCARE AT MCHS-ALBERT LEA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 26 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 201110 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 147203 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 219862 | InvestmentIncomePriorYear |
| Investment Income Current Year | 216023 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -16348 | OtherRevenuePriorYear |
| Other Revenue Current Year | 15470 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 404624 | TotalRevenuePriorYear |
| Total Revenue Current Year | 378696 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 515421 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 392122 | 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 | 22401 | OtherExpensePriorYear |
| Other Expenses Current Year | 24808 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 537822 | TotalExpensesPriorYear |
| Total Expenses Current Year | 416930 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -133198 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -38234 | RevenuesLessExpensesCY |
| Total Assets BOY | 5538986 | TotalAssetsBOY |
| Total Assets EOY | 4897080 | TotalAssetsEOY |
| Total Liabilities BOY | 707054 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 475845 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4831932 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4421235 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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 MAYO CLINIC HEALTH SYSTEMS IN ALBERT LEA AND SURROUNDING COMMUNITIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 269192 | Expense |
| Grants | 269192 | Grants |
| Description | NAEVE HEALTH CARE FOUNDATION'S 2011 GIFT OF $183,192 WAS DIRECTED TOWARDS "THE BEAT GOES ON" TO PURCHASE CARDIAC CARE EQUIPMENT FOR AREA FIRST RESPONDERS AND MCHS-ALBERT LEA'S AMBULANCE SERVICES, CARDIOLOGY, AND CARDIAC REHAB DEPARTMENTS. THE NCHF CHALLENGED THE COMMUNITY TO CONTRIBUTE TO "THE BEAT GOES ON" AND IN 2011 AN ADDITIONAL $86,000 WAS CONTRIBUTED TO MAYO CLINIC HEALTH SYSTEM-ALBERT LEA, FOR A TOTAL GIFT OF $269,192 DIRECTED TOWARDS "THE BEAT GOES ON". | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 123060 | Expense |
| Grants | 122930 | Grants |
| Description | THE FOUNDATION ALSO CONTINUED TO COLLECT GIFTS RELATED TO THE 2010 PROJECT PINK CAMPAIGN AND LONG-TERM CAPITAL CAMPAIGN. CONTRIBUTIONS FROM THESE EFFORTS AMOUNTED TO $41,000 AND $77,000 RESPECTIVELY WHICH WERE GIVEN TO MCHS-ALBERT LEA DURING 2011.ADDITIONALLY, THE FOUNDATION CONTRIBUTED A TOTAL OF $4,930 TO MCHS-ALBERT LEA IN 2011, OF WHICH $1,730 WAS DONATED THROUGH THE KASAL FUND TO SUPPORT PATIENTS OF MCHS-ALBERT LEA AND $3,200 WAS APPLIED TOWARDS PROGRAMS SUCH AS DIABETES EDUCATION, THE BABY PLACE, THE STROKE GROUP, AND FOUNTAIN CENTERS RECREATIONAL EQUIPMENT. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 392252 | 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 | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | 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 | 0 | 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 | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | 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 |
| 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 |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID BONNERUP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5073776380 | TelephoneNumber |
Address US AddressUS
| 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) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| ANDERSON JAMES | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BENDA HEATHER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BROWNLOW STEVE | ||||||
| TREASURER AND DIRECTOR | 1.00 | X | 0 | 0 | 0 | X |
| CLARK DIANE | ||||||
| SECRETARY AND DIRECTOR | 1.00 | X | 0 | 0 | 0 | X |
| ECKSTROM MD MICHAEL | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ERLANDSON KENT | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| HABBEN MARCIA | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JOHNSTON ALEX | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| KALIS HENRY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LADLIE PENNIE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MURRAY RICHARD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MYERS MD THEODORE P | ||||||
| PRESIDENT AND DIRECTOR | 1.00 | X | 0 | 0 | 0 | X |
| PULLEY BARB | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| RASK MD CLIFFORD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SKOPHAMMER NANCY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| VERMEDAHL CLAIRE | ||||||
| VICE PRESIDENT AND DIRECTOR | 1.00 | X | 0 | 0 | 0 | X |
| CIOTA MD MARK | ||||||
| EX-OFFICIO | 1.00 | 0 | 0 | 0 | X | |
| 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 |
| Fundraising Events | 40910 | FundraisingEvents |
| All Other Contributions | 106293 | AllOtherContributions |
| Total Contributions | 147203 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 128359 | TotalRevenueColumn |
| Exclusion | $128,359 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1250279 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1162615 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 87664 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 87664 | TotalRevenueColumn |
| Exclusion | $87,664 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 15470 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 40910 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 0 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15470 | TotalRevenueColumn |
| Exclusion | $15,470 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 378696 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $231,493 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 392122 | Total |
| Program Services | 392122 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24678 | Total |
| Management And General | 24678 | ManagementAndGeneral |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISC. EXPENSE | Description |
| Total | 130 | Total |
| Program Services | 130 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 416930 | Total |
| Program Services | 392252 | ProgramServices |
| Management And General | 24678 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 426911 | BOY |
| EOY | 174756 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 133793 | BOY |
| EOY | 45966 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4955340 | BOY |
| EOY | 4658552 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22942 | BOY |
| EOY | 17806 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5538986 | BOY |
| EOY | 4897080 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 707054 | BOY |
| EOY | 475845 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 707054 | BOY |
| EOY | 475845 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4312337 | BOY |
| EOY | 4000976 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 218052 | BOY |
| EOY | 118716 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 301543 | BOY |
| EOY | 301543 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4831932 | BOY |
| EOY | 4421235 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5538986 | BOY |
| EOY | 4897080 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -38234 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -372463 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1581314 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 310716 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 61465 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 201110 | CurrentTaxYearMinus1Year |
| Current Tax Year | 147203 | CurrentTaxYear |
| Total | 2301808 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1581314 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 310716 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 61465 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 201110 | CurrentTaxYearMinus1Year |
| Current Tax Year | 147203 | CurrentTaxYear |
| Total | 2301808 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 48090 | AmountsSubstContributorsTotal |
| Public Support Total170 | 2253718 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 181073 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 224173 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 144279 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 117588 | CurrentTaxYearMinus1Year |
| Current Tax Year | 128359 | CurrentTaxYear |
| Total | 795472 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 15470 | CurrentTaxYear |
| Total | 15470 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 3112750 | TotalSupport |
| Public Support Pertcentage170 | 0.72400 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.71580 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GROSS RECEIPTS FROM FUNDRAISING EVENT | GeneralExplanation |
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) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 301543 | BeginningOfYearBalance |
| End Of Year Balance | 301543 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 301543 | BeginningOfYearBalance |
| End Of Year Balance | 301543 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 281543 | BeginningOfYearBalance |
| Contributions | 20000 | Contributions |
| End Of Year Balance | 301543 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 281543 | BeginningOfYearBalance |
| End Of Year Balance | 281543 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | WELLS FARGO INVESTMENTS | Description |
| Book Value | 4658552 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 4658552 | TotalOfBookValueSecurities |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 2B: | THE FOUNDATION HOLDS FUNDS ON BEHALF OF MAYO CLINIC HEALTH SYSTEM-ALBERT LEA. THE FOUNDATION HAS SIGNATURE AUTHORITY OVER THESE FUNDS AND INVESTS THEM ON BEHALF OF MCHS-ALBERT LEA. THESE FUNDS ARE SEGREGATED ON THE BOOKS AND RECORDS OF THE FOUNDATION. | |
| PART V, LINE 4: | TO SUPPORT PATIENTS OF MAYO CLINIC HEALTH SYSTEM-ALBERT LEA AND PROVIDE SCHOLARSHIPS FOR STUDENTS FOR FOUNTAIN CENTERS. | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | THE BEAT GOES ON | NameOfEvent1 |
| Gross Receipts Event1 | 56380 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 40910 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 15470 | GrossRevenueEvent1 |
| Gross Receipts Total | 56380 | GrossReceiptsTotal |
| Charitable Contributions Total | 40910 | CharitableContributionsTotal |
| Gross Revenue Total Events | 15470 | GrossRevenueTotalEvents |
| Net Income Summary | 15470 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM-ALBERT LEA | BusinessNameLine1 |
Address US AddressUS
| 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) |
|---|---|---|
| EIN Of Recipient | 411404075 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 392122 | AmountOfCashGrant |
| Purpose Of Grant | SUPPORT PROGRAMS OF ALBERT LEA MEDICAL CENTER -- MAYO HEALTH SYSTEM | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: CHECKS ARE ISSUED TO THE MCHS-ALBERT LEA. SINCE THE GRANTS ARE USED TO SUPPORT THE OPERATIONS OF MCHS-ALBERT LEA, AND SINCE THE FOUNDATION'S MISSION IS TO PROVIDE FINANCIAL SUPPORT TO MCHS-ALBERT LEA, THE GRANTS CAN ONLY BE USED FOR THE INTENDED PURPOSE. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | MICHAEL ECKSTROM, M.D. HAD A BUSINESS RELATIONSHIP WITH NANCY SKOPHAMMER. | |
| FORM 990, PART VI, SECTION A, LINE 3 | DEVELOPMENT OFFICER IS AN EMPLOYEE OF MAYO CLINIC HEALTH SYSTEM-ALBERT LEA. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW BY TAX UNIT PRIOR TO SUBMISSION TO SITE PERSONNEL. THE TAX RETURN IS THEN REVIEWED BY SITE FINANCE STAFF AND THE DEVELOPMENT OFFICER. THE TAX RETURN IS FORWARDED TO THE ORGANIZATION'S GOVERNING BODY. QUESTIONS ARE ADDRESSED AND RETURN IS APPROVED BY THE GOVERNING BODY. APPROVAL IS DOCUMENTED AS A PART OF THE MEETING MINUTES. | |
| FORM 990, PART VI, SECTION B, LINE 12C | IN ACCORDANCE WITH CONFLICT OF INTEREST POLICY -- ANNUALLY THE FOLLOWING WILL BE REQUIRED TO SIGN A CONFLICT OF INTEREST ACKNOWLEDGEMENT: A.BOARD OF TRUSTEE MEMBERS B.COMMITTEE MEMBERS OF THE MAJOR NHCF COMMITTEES C.EMPLOYEES OF NHCF AND/OR THE DEVELOPMENT OFFICER 2.AN INDIVIDUAL FROM THE ABOVE GROUPS MAY BE ASKED TO ABSTAIN FROM VOTING OR PARTICIPATING IN THE DECISION MAKING ACTIVITIES AFFECTED BY THE DISCLOSURE. 3.AN INDIVIDUAL MAY BE ASKED TO LEAVE A MEETING WHERE THE DECISION MAKING ACTIVITIES WOULD BE AFFECTED BY THE DISCLOSURE. 4.IF AN INDIVIDUAL NEGLECTS TO DISCLOSE APPROPRIATELY, DISCIPLINARY ACTION WILL BE CONSIDERED UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR POSITION ON THE BOARD. THE COMPLIANCE OFFICER OF MCHS-ALBERT LEA ASSISTS THE BOARD IN DISTRIBUTION AND COLLECTION OF ANNUAL DISCLOSURE FORMS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -341,757. PLEDGE WRITE-OFFS -30,706. TOTAL TO FORM 990, PART XI, LINE 5: -372,463. | CHANGES IN NET ASSETS OR FUND BALANCES: |
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