CHISHOLM HEALTH CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CHISHOLM HEALTH CENTER (EIN 41-1879639)
Tax period
2011-07-01 to 2012-06-30
Filed
2012-12-20
IRS object ID
201213559349300436
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

FieldValueIRS element (for citing)
Timestamp2012-12-20T15:06:49-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CONWAY DEUTH & SCHMIESING PLLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1401 ATLANTIC AVEAddressLine1
CityMORRISCity
StateMNState
ZIP Code562671324ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411879639EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHISHOLM HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHISNameControl
Phone2182545765Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1321 NE 6TH STREETAddressLine1
CityCHISHOLMCity
StateMNState
ZIP Code55719ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLUVERNE HOFFMANName
TitlePRESIDENTTitle
Phone2182545765Phone
Date Signed2012-12-17DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAMES A GILMAN CPAName
Phone3205892602Phone
Date Prepared2012-12-17DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLUVERNE HOFFMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1801 NEVADA AVEAddressLine1
CityMORRISCity
StateMNState
ZIP Code56267ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6183076GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SFHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionWE 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 Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees153TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2198ContributionsGrantsPriorYear
Contributions Grants Current Year2919ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6441664ProgramServiceRevenuePriorYear
Program Service Revenue CY6151072ProgramServiceRevenueCY
Investment Income Prior Year-798InvestmentIncomePriorYear
Investment Income Current Year398InvestmentIncomeCurrentYear
Other Revenue Prior Year47896OtherRevenuePriorYear
Other Revenue Current Year27454OtherRevenueCurrentYear
Total Revenue Prior Year6490960TotalRevenuePriorYear
Total Revenue Current Year6181843TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year8097GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3499380SalariesEtcPriorYear
Salaries Etc Current Year3489153SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2239665OtherExpensePriorYear
Other Expenses Current Year2116578OtherExpensesCurrentYear
Total Expenses Prior Year5747142TotalExpensesPriorYear
Total Expenses Current Year5605731TotalExpensesCurrentYear
Revenues Less Expenses Prior Year743818RevenuesLessExpensesPriorYear
Revenues Less Expenses CY576112RevenuesLessExpensesCY
Total Assets BOY6265397TotalAssetsBOY
Total Assets EOY6504056TotalAssetsEOY
Total Liabilities BOY4865982TotalLiabilitiesBOY
Total Liabilities EOY4528529TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1399415NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1975527NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWE 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 ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4988748Expense
Revenue6183075Revenue
DescriptionCHISHOLM HEALTH CENTER IS A 85 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 27,938 PATIENT DAYS AND PROVIDED SERVICES TO MORE THAN 217 PATIENTS. ALSO DURING THIS TIME PERIOD, THE ORGANIZATION EMPLOYED ABOUT 93 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 2.8 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE VERY LIMITED.Description
Total Program Service Expense4988748TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees153NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSHERRY WAGNERNamePerson
Telephone Number3205894919TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1801 NEVADA AVENUEAddressLine1
CityMORRISCity
StateMNState
ZIP Code56267ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
DON GIESELMANN
CHAIR1.00XX000
STEVE LIENEMANN
TRUSTEE1.00X000
KATIE ERDMAN
TRUSTEE1.00X000
MAGGIE FLETCHER
TRUSTEE1.00X000
BARBARA SPAULDING
TRUSTEE1.00X000
DOUGLAS WARTNER
TRUSTEE1.00X000
ANDY LOPEZ
VICE CHAIR1.00XX000
KENNY WESTBROCK
TRUSTEE1.00X000
KEN KELLER
TRUSTEE1.00X000
RANDY SUTTER
SEC/TREASURE1.00XX000
FATHER ROBERT KIEFFER
TRUSTEE1.00X000
ROSE MURPHY
TRUSTEE1.00X000
NEIL SCHMIDGALL
TRUSTEE1.00X000
LUVERNE HOFFMAN
PRES/CEO1.00X020801723442
CAROL RAW
VP SENIOR SVX014655014696
ROBERT WIKAN
CFO DEC-MARC1.00X01080235481
DENNIS LINDOR
VP BEHAV SVCX09087614783
SHERRY WAGNER
CFO MARCH-PR1.00X0720583802
JUNE SCHELDE
ADMIN - GAHR011558815084X
SCOTT JACKSON
DIRECTOR OF01074656870X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs848577TotalReportableCompFrmRltdOrgs
Total Other Compensation84158TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ST FRANCIS HEALTH SERVICES
801 NEVADA AVEMORRISMN56267MANAGEMENT FEES358600
JOHNSON WILSON CONTRACTORS INC
PO BOX 16006DULUTHMN55816CONSTRUCTION152871
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions2919AllOtherContributions
Total Contributions2919TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET RESIDENT SERVICE REVENUEDescription
Total Revenue Column6151072TotalRevenueColumn
Related Or Exempt Function Income6151072RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6151072TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column398TotalRevenueColumn
Exclusion$398ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events2172GrossIncomeFundraisingEvents
Fundraising Direct Expenses1233FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column939TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
APARTMENT RENTAL1717017170
GUEST, EMPLOYEE & APT MEALS66826682
MISCELLANEOUS26632663
FieldValueIRS element (for citing)
Total Other Revenue26515TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6181843TotalRevenueColumn
Related Or Exempt Function Income6177587RelatedOrExemptFunctionIncome
Exclusion$398ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2869968Total
Program Services2801375ProgramServices
Management And General68593ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total93965Total
Program Services91719ProgramServices
Management And General2246ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total309456Total
Program Services302060ProgramServices
Management And General7396ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total215764Total
Program Services210607ProgramServices
Management And General5157ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total358600Total
Management And General358600ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total427Total
Management And General427ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6235Total
Management And General6235ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total11363Total
Management And General11363ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22930Total
Management And General22930ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total143192Total
Program Services143192ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total2643Total
Management And General2643ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total3523Total
Program Services1668ProgramServices
Management And General1855ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total175284Total
Program Services175284ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total282131Total
Program Services282131ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total56833Total
Management And General56833ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES477040477040
MEDICAL SURCHARGE248658248658
MEDICAL PROF. FEES1118588460927249
CONSULTING7435074350

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total141511Total
Program Services96055ProgramServices
Management And General45456ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5605731Total
Program Services4988748ProgramServices
Management And General616983ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1006334BOY
EOY581062EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY552329BOY
EOY719698EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY35069BOY
EOY36409EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8152123LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3091570LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4556133BOY
EOY5060553EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY115532BOY
EOY106334EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6265397BOY
EOY6504056EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY475751BOY
EOY484313EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4280529BOY
EOY3984365EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY9702BOY
EOY9542EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY100000BOY
EOY50309EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4865982BOY
EOY4528529EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1399415BOY
EOY1975527EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1399415BOY
EOY1975527EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6265397BOY
EOY6504056EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses576112ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years500CurrentTaxYearMinus4Years
Current Tax Year Minus1 Year2198CurrentTaxYearMinus1Year
Current Tax Year2919CurrentTaxYear
Total5617Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6167190CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6600929CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6675129CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6491058CurrentTaxYearMinus1Year
Current Tax Year6179759CurrentTaxYear
Total32114065Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6167690CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6600929CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6675129CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6493256CurrentTaxYearMinus1Year
Current Tax Year6182678CurrentTaxYear
Total32119682Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years255065CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years163875CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years353316CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year290457CurrentTaxYearMinus1Year
Current Tax Year478975CurrentTaxYear
Total1541688Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years255065CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years163875CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years353316CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year290457CurrentTaxYearMinus1Year
Current Tax Year478975CurrentTaxYear
Total1541688Total
FieldValueIRS element (for citing)
Public Support Total50930577994PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years31416CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4568CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2472CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year984CurrentTaxYearMinus1Year
Current Tax Year398CurrentTaxYear
Total39838Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years31416CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4568CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2472CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year984CurrentTaxYearMinus1Year
Current Tax Year398CurrentTaxYear
Total39838Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6199106CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6605497CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6677601CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6494240CurrentTaxYearMinus1Year
Current Tax Year6183076CurrentTaxYear
Total32159520Total
FieldValueIRS element (for citing)
Public Support Percentage5090.95080PublicSupportPercentage509
Prior Year Support Percentage0.95660PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtctrueAgentTrusteeEtc
Beginning Balance9702BeginningBalance
Additions During Year25605AdditionsDuringYear
Distributions During Year-25765DistributionsDuringYear
Ending Balance9542EndingBalance
Included On FStrueIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis10000OtherCostOrOtherBasis
Book Value10000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6921417OtherCostOrOtherBasis
Depreciation2720402Depreciation
Book Value4201015BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis452636OtherCostOrOtherBasis
Depreciation371168Depreciation
Book Value81468BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis768070OtherCostOrOtherBasis
Book Value768070BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5060553TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO RELATED PARTYDescription
Amount$50,309Amount
FieldValueIRS element (for citing)
Total Of Amounts50309TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXPLANATION FOR UNREPORTED CONTRIBUTIONS OR ASSETSSCHEDULE D, PAGE 2, PART IV, LINE 1BTHE ORGANIZATION ACTS AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS.
ESCROW LIABILITY ARRANGEMENT EXPLANATIONSCHEDULE D, PAGE 2, PART IV, LINE 2BTHE ORGANIZATION ACTS AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
LUVERNE HOFFMAN
208017964113801231459
CAROL RAW
14655074617235161246

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1BREMER BANKBusinessNameLine1
Business Name Line2HCF REV NOTE 2009ABusinessNameLine2
FieldValueIRS element (for citing)
Issuer EIN416005047IssuerEIN
Date Issued2009-10-21DateIssued
Issue Price1143804IssuePrice
Description Of PurposeREFINANCING TAXABLEDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadefalseFinalAllocationMade
Adequate Books And Recds MaintaindfalseAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Engage Bond Counsel ContractsfalseEngageBondCounselContracts
Any Research AgreementsfalseAnyResearchAgreements
Engage Bond Counsel ResearchfalseEngageBondCounselResearch
Post Issuance Compliance ProcdrsfalsePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPURPOSE OF ISSUE DESCRIPTIONIdentifier
Return ReferenceSCHEDULE KReturnReference
ExplanationBREMER BANK INDEBTEDNESS INCURRED TO FINANCE GENERAL REMODELING INFRASTRUCTURE IMPROVEMENTS AND WINDOW REPLACEMENT AT CHCExplanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MARK HOFFMAN
FAMILY TO54006EMPLOYED INfalse
(no name)
LUVERNE HOFFMANMAINTENANCEfalse
(no name)
PRES & CEOfalse
ELIZABETH LETICH
DAUGHTER OF64272EMPLOYED AS ANfalse
(no name)
CAROL RAWADMINISTRATORfalse
(no name)
VICE PRESIDENTfalse
ANDREW RAW
SON OF26945EMPLOYED INfalse
(no name)
CAROL RAWMAINTENANCEfalse
(no name)
VICE PRESIDENTfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
ExplanationDURING 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 PURPOSEExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONWE 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 DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4AEMPLOYMENT OPPORTUNITIES ARE VERY LIMITED.
MANAGEMENT DELEGATEDFORM 990, PAGE 6, PART VI, LINE 3ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION WITH COMMON CONTROL) MANAGES THE FACILITY.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6THE 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 990FORM 990, PAGE 6, PART VI, LINE 11BTHE CFO OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC REVIEWS THE TAX RETURN AS PART OF THE MANAGEMENT SERVICES.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CANNUALLY 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 OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE 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 OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE 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 EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON AN AS REQUESTED BASIS.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIIST. FRANCIS HEALTH SERVICES OF MORRIS, INC HAS A MANAGEMENT AGREEMENT WITH THE RELATED ENTITY.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
AITKIN HEALTH SERVICES
301 MINNESOTA AVENUEAITKINMN56431203367397CAREGIVERMN501C39SFHSfalse
BROWNS VALLEY HEALTH CENTER
RR 1 BOX 182D SOUTH JEFFERSONBROWNS VALLEYMN56219411668347CAREGIVERMN501C39SFHSfalse
FRANCISCAN HEALTH CENTER
3910 MINNESOTA AVENUEDULUTHMN55802411799268CAREGIVERMN501C39SFHSfalse
FARMINGTON HEALTH SERVICES
3410 23RD STREET WFARMINGTONMN55024200100365CAREGIVERMN501C39SFHSfalse
GUARDIAN ANGELS HEALTH & REHAB CENT
1500 3RD AVENUE EHIBBINGMN55746411810369CAREGIVERMN501C39SFHSfalse
PRAIRIE COMMUNITY SERVICES
801 NEVADA AVENUEMORRISMN56267411598442CAREGIVERMN501C39SFHSfalse
PENNINGTON HEALTH SERVICES
130 LABREE AVENUE STHIEF RIVER FALLSMN56701205617275CAREGIVERMN501C39SFHSfalse
RENVILLE HEALTH SERVICES
205 SE ELM AVENUERENVILLEMN56284202581924CAREGIVERMN501C39SFHSfalse
ST FRANCIS HEALTH SERVICES (SFHS)
801 NEVADA AVENUEMORRISMN56267411484416MGMT COMPMN501C39falseN/A
VIEWCREST HEALTH CENTER
3111 CHURCH PLACEDULUTHMN55811411843283CAREGIVERMN501C39SFHSfalse
WEST WIND VILLAGE
1001 SCOTT AVENUEMORRISMN56267237625632CAREGIVERMN501C39SFHSfalse
ZUMBROTA HEALTH SERVICES
433 MILL STREETZUMBROTAMN55992510487275CAREGIVERMN501C39SFHSfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1ST FRANCIS HEALTH SERVICES OF MORRBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeLTransactionType
Amount Involved358600AmountInvolved
Method Of Amt DeterminationAMOUNT PAID OR ACCRUEDMethodOfAmtDetermination

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE RReturnReference
ExplanationST FRANCIS HEALTH SERVICES OF MORRIS INC HAS GUARANTEED EXISTING LOANS OF 3984364 AS SHOWN IN FORM 990 PART X LINE 20 THERE WERE NO NEW LOAN GUARANTEES DURING THE FISCAL YEARExplanation

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