LAKE REGION HEALTHCARE FOUNDATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
LAKE REGION HEALTHCARE FOUNDATION (EIN 41-1677288)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-05-16
IRS object ID
201131369349305813
Schema version
2009v1.2
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)
Timestamp2011-05-16T10:45:50-07:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411677288EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LAKE REGION HOSPITAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLAKENameControl
Phone2187368000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1712 S CASCADE STAddressLine1
CityFERGUS FALLSCity
StateMNState
ZIP Code565380728ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameEDWARD STRAND CPA INACTIVEName
TitleSR VP/CFOTitle
Phone2187368000Phone
Date Signed2011-05-13DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLARRY SCHULZNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1712 S CASCADE STAddressLine1
Address Line2PO BOX 728AddressLine2
CityFERGUS FALLSCity
StateMNState
ZIP Code565380728ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1578963GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Type Of Organization OtherXTypeOfOrganizationOther
Type Of Org Other DescriptionFoundationTypeOfOrgOtherDescription
Year Formation2000YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTHE 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 Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2667792ContributionsGrantsPriorYear
Contributions Grants Current Year1172444ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year17599InvestmentIncomePriorYear
Investment Income Current Year27685InvestmentIncomeCurrentYear
Other Revenue Prior Year-4885OtherRevenuePriorYear
Other Revenue Current Year-11508OtherRevenueCurrentYear
Total Revenue Prior Year2680506TotalRevenuePriorYear
Total Revenue Current Year1188621TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year60789GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY303480GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year13098OtherExpensePriorYear
Other Expenses Current Year4476OtherExpensesCurrentYear
Total Expenses Prior Year73887TotalExpensesPriorYear
Total Expenses Current Year307956TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2606619RevenuesLessExpensesPriorYear
Revenues Less Expenses CY880665RevenuesLessExpensesCY
Total Assets BOY5985271TotalAssetsBOY
Total Assets EOY6393068TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5985271NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6393068NetAssetsOrFundBalancesEOY
Mission DescriptionTHE 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense307956Expense
Grants303480Grants
Revenue27685Revenue
DescriptionLAKE 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. A LOT OF EMPHASIS WAS PUT ON RAISING FUNDS FROM THE COMMUNITY TO BUILD A CANCER CENTER ON LAKE REGION HEALTHCARE'S CAMPUS. THE GOAL OF THE FOUNDATION LED TO THE COMPLETION OF CONSTRUCTION OF THE NEW CANCER CENTER IN EARLY 2010.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense307956TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported0BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding0ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LAKE REGION HEALTHCARE CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2187368000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1712 S CASCADE STAddressLine1
Address Line2PO BOX 728AddressLine2
CityFERGUS FALLSCity
StateMNState
ZIP Code565380728ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
LARRY DORN
PRESIDENT2.00X000
SOLVEIG HALBAKKEN
VICE CHAIR2.00X000
DENNIS EMMEN
SECRETARY/TREASURER2.00X000
DAVID JOHNSON
TRUSTEE2.00X000
STEPHEN RUFER
TRUSTEE2.00X000
LESLIE SYVERSON MD
TRUSTEE2.00X000
GARY SPIES
TRUSTEE2.00X000
MARY LAMPY VELO
TRUSTEE2.00X000
DAVID BJORK MD
TRUSTEE2.00X000
PAUL ETZELL MD
TRUSTEE2.00X000
LINDA MATTER PHD
TRUSTEE2.00X000
DAVE BICKETT
TRUSTEE2.00X000
KIM EMBRETSON CFRE
TRUSTEE2.00X000
TODD MCGOVERN DDS
TRUSTEE2.00X000
DIC PICKET CPA
TRUSTEE2.00X000
CRYSTAL ADAMS
TRUSTEE2.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions1172444AllOtherContributions
Noncash Contributions239396NoncashContributions
Total Contributions1172444TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column46509TotalRevenueColumn
Related Or Exempt Function Income46509RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities289947Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities308771Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-18824Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-18824TotalRevenueColumn
Related Or Exempt Function Income-18824RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events70063GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses81571FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-11508TotalRevenueColumn
Related Or Exempt Function Income-11508RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1188621TotalRevenueColumn
Related Or Exempt Function Income16177RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total303480Total
Program Services303480ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1841Total
Program Services1841ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total128Total
Program Services128ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total50Total
Program Services50ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MISCELLANEOUS EXPENSE1662166200
REAL ESTATE TAX53153100
MEALS EXPENSE18018000
SERVICE CHARGES848400

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total307956Total
Program Services307956ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY968166BOY
EOY1436499EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3022198BOY
EOY2570687EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1994907BOY
EOY2385882EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5985271BOY
EOY6393068EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5985271BOY
EOY6393068EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5985271BOY
EOY6393068EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5985271BOY
EOY6393068EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling Individual1ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1LAKE REGION HEALTHCARE CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
EIN410730602EIN
Type Of Organization170(b)(1)(A)(iii)TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$21,740Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts21740SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Revenue1188621TotalRevenue
Total Expenses307956TotalExpenses
Excess Or Deficit For Year880665ExcessOrDeficitForYear
Net Unrealized GL On Investments128747NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other-$601,614OtherAmount
Total Adjustments-472867TotalAdjustments
Excess Or Deficit Per FS407798ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1188621TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal1188621RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901188621TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt307956TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal307956ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990307956TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSchD_P11_S00_L08Identifier
Return ReferenceSchedule D, Part XI, Line 8ReturnReference
ExplanationRELATED COMPANY TRANSFERSExplanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1PRCA RODEONameOfEvent1
Gross Receipts Event116863GrossReceiptsEvent1
Charitable Contributions Event10CharitableContributionsEvent1
Gross Revenue Event116863GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event10NonCashPrizesEvent1
Rent Facility Costs Event10RentFacilityCostsEvent1
Food And Beverage Event10FoodAndBeverageEvent1
Entertainment Event10EntertainmentEvent1
Other Direct Expenses Event119242OtherDirectExpensesEvent1
Name Of Event2NEW YEARS GALANameOfEvent2
Gross Receipts Event218350GrossReceiptsEvent2
Charitable Contributions Event20CharitableContributionsEvent2
Gross Revenue Event218350GrossRevenueEvent2
Cash Prizes Event20CashPrizesEvent2
Non Cash Prizes Event20NonCashPrizesEvent2
Rent Facility Costs Event20RentFacilityCostsEvent2
Food And Beverage Event20FoodAndBeverageEvent2
Entertainment Event20EntertainmentEvent2
Other Direct Expenses Event221145OtherDirectExpensesEvent2
Total Number Of Other Events10TotalNumberOfOtherEvents
Gross Receipts Other Events34850GrossReceiptsOtherEvents
Charitable Contrib Other Events0CharitableContribOtherEvents
Gross Revenue Other Events34850GrossRevenueOtherEvents
Cash Prizes Other Events0CashPrizesOtherEvents
Non Cash Prizes Other Events0NonCashPrizesOtherEvents
Rent Facility Costs Other Events0RentFacilityCostsOtherEvents
Food And Beverage Other Events0FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Other Direct Expenses Other Events41184OtherDirectExpensesOtherEvents
Gross Receipts Total70063GrossReceiptsTotal
Charitable Contributions Total0CharitableContributionsTotal
Gross Revenue Total Events70063GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events0NonCashPrizesTotalEvents
Rent Facility Costs Total Events0RentFacilityCostsTotalEvents
Food And Beverage Total Events0FoodAndBeverageTotalEvents
Entertainment Total Events0EntertainmentTotalEvents
Other Direct Expenses Total Events81571OtherDirectExpensesTotalEvents
Direct Expense Summary Events81571DirectExpenseSummaryEvents
Net Income Summary-11508NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1LAKELAND HOSPICE AND HOME CARE INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 824AddressLine1
CityFERGUS FALLSCity
StateMNState
ZIP Code56537ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient363255877EINOfRecipient
Amount Of Cash Grant288138AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Purpose Of GrantCONTINUED OPERATIONSPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchI_P01_S00_L02Identifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationGRANTS 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

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions10NumberOfContributions
Noncash Contribs Rptd F990239396NoncashContribsRptdF990
Method Of Determining RevenuesMarket ValueMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11Form 990, Part VI, Section B, Line 11THE 990 IS PRESENTED TO A COMMITTEE THAT IS DESIGNATED BY THE BOARD OF DIRECTORS FOR APPROVAL.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cOFFICERS AND TRUSTEES ANNUALLY ASSESS WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST ACCORDING TO THE CONFLICTS OF INTEREST POLICY. IT IS CONSISTANTLY MONITORED DURING THE YEAR TO BE SURE THAT THE POLICY IS BEING FOLLOWED.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1Address Line2AddressUS/AddressLine2CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1
LAKE REGION HEALTHCARE CORPORATION
712 S CASCADE STPO BOX 728FERGUS FALLSMN565380728410730602HOSPITALMN501(C)(3)N/A
LRHC LONG TERM CARE FACILITIES INC
712 S CASCADE STPO BOX 728FERGUS FALLSMN565380728411817549NURSING HOMEMN501(C)(3)LAKE REGION HEALTHCARE CORPORATION
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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