2024-11-08T08:12:37-06:00 2023-12-31 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2023-01-01 450344371 F-M AMBULANCE SERVICE INC F-MA 7012342000 PO BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 NICHOLAS OLSON EVP, CFO 6053331000 2024-11-08 1 0 JESS WAGENER P01622613 3128792000 2023 2024-10-15 13:58:12Z BILL GASSEN 2301 EAST 60TH ST SIOUX FALLS SD 57104 16042543 0 X WWW.FMAMBULANCE.COM X 1978 ND "DEDICATED TO THE WORK OF HEALTH AND HEALING" 10 5 0 0 0 0 355853 258925 18404157 15775616 41226 0 13978 7149 18815214 16041690 0 0 0 0 12412945 13677966 0 0 0 4896679 3337147 17309624 17015113 1505590 -973423 8237188 7813842 65783 107549 8171405 7706293 X THE MISSION OF F-M AMBULANCE, "DEDICATED TO SHARING GOD'S LOVE THROUGH THE WORK OF HEALTH, HEALING AND COMFORT AND THE VISION "IMPROVING THE HUMAN CONDITION THROUGH EXCEPTIONAL CARE, INNOVATION AND DISCOVERY", IS THE CONSTANT FORCE THAT DRIVES OUR PLANS, DECISIONS AND ACTIONS. 0 0 14844360 15775616 AS PART OF THE SANFORD HEALTH INTEGRATED DELIVERY SYSTEM, FM AMBULANCE, DBA SANFORD AMBULANCE FARGO (SA-F), PROVIDES EMERGENCY MEDICAL CARE AND SPECIALTY CARE TRANSPORTATION SERVICES TO FARGO, NORTH DAKOTA/MOORHEAD, MINNESOTA METRO AREA AND SURROUNDING COMMUNITIES. SA-F IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF AMBULANCE SERVICES (CAAS) AND IS THE LARGEST ADVANCED LIFE SUPPORT GROUND AMBULANCE PROVIDER IN NORTH DAKOTA AND OUTSTATE MINNESOTA. SA-F RESPONDS TO MORE THAN 32,000 CALLS FOR SERVICE ANNUALLY WHICH RESULTED IN TRANSPORTING MORE THAN 23,000 PEOPLE AND OVER 9,000 CALLS THAT DID NOT RESULT IN A PATIENT TRANSPORT. SA-F SERVES AS A RESOURCE TO RESCUE SQUADS, FIRE DEPARTMENTS, LAW ENFORCEMENT AGENCIES AND BASIC LIFE SUPPORT AMBULANCE PROVIDERS THROUGHOUT THE STATE. SA-F PROVIDES TACTICAL PARAMEDICS FOR THE REGIONAL S.W.A.T. TEAM AND PROVIDES FIREFIGHTER REHAB SERVICES PRO-BONO. SA-F WORKS CLOSELY WITH LOCAL VOLUNTEER SERVICES TO COORDINATE THE DELIVERY OF EMERGENCY MEDICAL CARE TO COMMUNITIES IN ITS SERVICE AREA AND IS A LEADER IN HOMELAND DEFENSE PREPAREDNESS BY SERVING AS A REGIONAL TRAINING SITE, RESOURCES PARTNER AND FIRST RESPONDER.THROUGH ITS READY WHEELS OPERATIONS (A SPECIALTY CARE TRANSPORTATION SERVICE), SA-F PROVIDES LOCAL AND LONG DISTANCE TRANSPORTATION FOR INDIVIDUALS CONFINED TO WHEELCHAIRS. THIS SPECIALTY CARE TRANSPORTATION SERVICE IS AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO PROVIDE DOOR-TO-DOOR SERVICE. THESE SERVICES ALLOW INDIVIDUALS IN THE COMMUNITY TO ACCESS TRANSPORTATION SERVICES THAT ACCOMMODATE UNIQUE INDIVIDUAL NEEDS DUE TO HEALTH CONDITIONS.EDUCATION AND OTHER SERVICES:SA-F PROMOTES COMMUNITY HEALTH AND INJURY PREVENTION WITH MORE THAN 3,700 MEMBERS OF THE PUBLIC EACH YEAR PARTICIPATING IN FIRST AID, AUTOMATED EXTERNAL DEFIBRILLATOR, CPR, BABYSITTER TRAINING AND OTHER COMMUNITY WELLNESS COURSES. SA-F IS ALSO THE HOME TO THE REGION'S LARGEST INITIAL EMS CERTIFICATION CENTER. EMERGENCY MEDICAL RESPONDER CLASSES ARE TAUGHT TO AREA FIRE DEPARTMENTS, LAW ENFORCEMENT AGENCIES AND LOCAL OR INDUSTRIAL RESCUE SQUADS. EMT CLASSES ARE HELD MULTIPLE TIMES A YEAR AND SUPPLY STAFFING FOR FULL-TIME AND VOLUNTEER AGENCIES ACROSS THE AREA. IN CONJUNCTION WITH THE NORTH DAKOTA STATE COLLEGE OF SCIENCE, SA-F'S PARAMEDIC PROGRAM OFFERS AN ASSOCIATE DEGREE LEVEL COURSE ACCREDITED BY THE COMMISSION ON ACCREDITATION OF ALLIED HEALTH EDUCATION PROGRAMS (ONE OF 3 IN ND). SA-F ALSO OFFERS RECERTIFICATION COURSES IN-PERSON AND VIRTUALLY THAT ARE ACCREDITED THROUGH THE COMMISSION ON ACCREDITATION FOR PRE-HOSPITAL CONTINUING EDUCATION (ONLY ONE IN ND). SEVERAL OF THE EDUCATORS ARE ACTIVE REGIONALLY AND NATIONALLY ON EMS EDUCATION TOPICS. 14844360 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 X 10 5 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X NICHOLAS OLSON EVP CFO 6053331000 2301 EAST 60TH STREET SIOUX FALLS SD 57104 X MICHELLE BRUHN EVP, CFO & TREASURER (END 6/23) 0.50 59.50 X 0 3526262 105043 BILL GASSEN TRUSTEE, PRESIDENT & CEO 0.50 59.50 X X 0 2821352 439680 BILL MARLETTE INTERIM, EVP, CFO (BEG 6/23) 0.50 59.50 X 0 1306330 378 TIFFANY LAWRENCE PRESIDENT & CEO, FARGO 5.00 55.00 X 0 1071549 174779 MARK LUNDEEN MD TRUSTEE, PHYSICIAN 0.50 59.50 X 0 591873 16560 ANDY NORTH TRUSTEE, SECRETARY, INDEP CONTRACTOR 0.50 6.61 X X 0 324345 0 NEIL GULSVIG TRUSTEE, CHAIRPERSON 0.50 6.61 X X 0 66718 0 BRENT TEIKEN TRUSTEE, PAST CHAIR 0.50 6.61 X X 0 38404 0 DON JACOBS TRUSTEE (END 12/23) 0.50 6.61 X 0 37332 0 LAURIS MOLBERT TRUSTEE, VICE CHAIR 0.50 6.61 X X 0 37099 0 JAMES CAIN TRUSTEE 0.50 6.61 X 0 35599 0 WESLEY ENGBRECHT TRUSTEE 0.50 6.61 X 0 34599 0 MARNIE HERMANN TRUSTEE, TREASURER (BEG 4/23) 0.50 6.61 X X 0 32099 0 ROBIN SMITH TRUSTEE, TREASURER (END 4/23) 0.50 6.61 X X 0 11000 0 0 9934561 736440 0 0 1 0 0 8249 250676 258925 EMERGENCY MEDICAL SERV 621910 15077707 15077707 EDUCATION 611430 514729 514729 CONTRACT/OUTREACH 624230 193948 193948 SPECIAL TRANSPORTATION 621910 -10768 -10768 15775616 8002 853 7149 7149 16041690 15775616 0 7149 11139622 10569408 570214 512131 485238 26893 1195069 1096921 98148 831144 792478 38666 157734 112642 45092 73790 62648 11142 209228 166329 42899 434267 241572 192695 440407 290470 149937 398010 382600 15410 257368 234872 22496 745262 706695 38567 357005 357005 MEDICAL SUPPLIES 1100431 1092977 7454 ALL OTHER EXPENSES 66900 40498 26402 CERTIFICATES, LIC, DUES 48711 34683 14028 MINNESOTACARE TAX 44016 44016 -995982 -1509687 513705 17015113 14844360 2170753 0 250 2388787 1406722 5975 5122 16997 -13597 12600670 8414431 3714888 4186239 1393082 1393082 717209 836274 8237188 7813842 65783 107549 65783 107549 X 8171405 7706293 8171405 7706293 8237188 7813842 X -973423 508311 X 0 1 X 1 0 410810 410810 2358545 1488725 869820 169295 51992 117303 5064648 3774850 1289798 4597372 3098864 1498508 4186239 OTHER ASSETS-CIP 836274 836274 X PART X, LINE 2: CERTAIN CONTROLLED ORGANIZATIONS ARE SUBJECT TO INCOME TAXES. DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE DIFFERENCES BETWEEN THE FINANCIAL AND INCOME TAX REPORTING BASIS OF ASSETS AND LIABILITIES BASED ON ENACTED TAX RATES AND LAWS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THE DEFERRED INCOME TAX PROVISION OR BENEFIT GENERALLY REFLECTS THE NET CHANGE IN DEFERRED INCOME TAX ASSETS AND LIABILITIES DURING THE YEAR. THE CURRENT INCOME TAX PROVISION REFLECTS THE TAX CONSEQUENCES OF REVENUES AND EXPENSES CURRENTLY TAXABLE OR DEDUCTIBLE ON VARIOUS INCOME TAX RETURNS FOR THE YEAR REPORTED. F-M AMBULANCE SERVICE, INC DID NOT HAVE AN INCOME TAX LIABILITY AT DECEMBER 31, 2023; SOME RELATED ORGANIZATIONS HAVE ESTABLISHED RESERVES. 1 1 0 0 0 1 1 0 0 MICHELLE BRUHN EVP, CFO & TREASURER (END 6/23) 0 517911 0 185400 0 2822951 0 88278 0 16765 0 3631305 0 430889 BILL GASSEN TRUSTEE, PRESIDENT & CEO 0 2105352 0 388071 0 327929 0 438925 0 755 0 3261032 0 0 BILL MARLETTE INTERIM, EVP, CFO (BEG 6/23) 0 856004 0 0 0 450326 0 0 0 378 0 1306708 0 0 TIFFANY LAWRENCE PRESIDENT & CEO, FARGO 0 806048 0 137733 0 127768 0 139200 0 35579 0 1246328 0 0 MARK LUNDEEN MD TRUSTEE, PHYSICIAN 0 310852 0 0 0 281021 0 16500 0 60 0 608433 0 0 ANDY NORTH TRUSTEE, SECRETARY, INDEP CONTRACTOR 0 324345 0 0 0 0 0 0 0 0 0 324345 0 0 PART I, LINE 1A CERTAIN ITEMS LISTED ON LINE 1A ARE PROVIDED BY RELATED ORGANIZATIONS. PART I, LINE 3 SANFORD ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO, AND TO REPORT THE FINDINGS TO THEM FOR DELIBERATION AND ACTION. THE DELIBERATIONS AND ACTIONS ARE RECORDED IN THE MINUTES OF THE SANFORD BOARD OF TRUSTEES. THE MOST RECENT STUDY WAS COMPLETED IN 2023. PART I, LINES 4A-B LINE 4A - SEVERANCE OR CHANGE OF CONTROL PAYMENT UPON HIRE OR PROMOTION, SELECT OFFICERS AND KEY EMPLOYEES SIGN AN EXECUTIVE SEVERANCE AGREEMENT (THE "AGREEMENT"). THE AGREEMENT PROVIDES THAT THE EXECUTIVE WILL RECEIVE A MULTIPLE OF HIS OR HER SALARY (BASED ON YEARS OF SERVICE OR POSITION) AS A PAYMENT IN THE EVENT OF A DEFINED SEPARATION EVENT, WHICH CAN INCLUDE AN INVOLUNTARY SEPARATION OR AN EMPLOYEE VOLUNTARILY LEAVING FOR A DEFINED CONTRACTUAL REASON. EXECUTIVE MAY ALSO QUALIFY FOR A PAYMENT FOR SATISFYING A NON-COMPETE. FINAL SEPARATION PAYMENTS MIGHT VARY FROM THE AMOUNT PROVIDED IN THE AGREEMENT AS A RESULT OF NEGOTIATIONS SURROUNDING POST-SEPARATION OBLIGATIONS AND INCENTIVES (THE "SEPARATION" PAYMENT). LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS SANFORD SPONSORS NONQUALIFIED RETIREMENT PLANS FOR SELECT OFFICERS OR KEY EMPLOYEES. CERTAIN OF THE BELOW OFFICERS OR KEY EMPLOYEES WERE PAID AS A RESULT OF A VESTING EVENT. LINES 4A AND 4B - PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS AND/OR SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: MICHELLE BRUHN: SEPARATION..................................$2,157,592 NONQUALIFIED RETIREMENT PLAN..................$576,899 TOTAL.......................................$2,734,491 BILL MARLETTE: NON-COMPETE PAYMENT...........................$436,802 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE EMPLOYEES OF SANFORD OR ITS RELATED ORGANIZATIONS. MANY OF THESE EMPLOYEES ALSO SERVE ON OTHER RELATED SANFORD BOARDS, OR HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER THAT SPAN THE ORGANIZATION AS A WHOLE: MARK LUNDEEN, TIFFANY LAWRENCE, MICHELLE BRUHN, BILL MARLETTE AND BILL GASSEN. FORM 990, PART VI, SECTION A, LINE 6 SANFORD NORTH IS THE SOLE STOCKHOLDER OF F-M AMBULANCE. FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS ARE APPOINTED BY THE PRESIDENT AND CEO OF SANFORD. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS BY THE BOARD OF DIRECTORS SHALL ALSO REQUIRE THE APPROVAL OF THE SHAREHOLDER: A. AMENDMENT OF THE CORPORATION'S GOVERNING DOCUMENTS INCLUDING, BUT NOT LIMITED TO, THE ARTICLES OF INCORPORATION OR BYLAWS; B. APPROVAL OF ANY MERGER, CONSOLIDATION, DISSOLUTION, OR LIQUIDATION OF THE CORPORATION; C. THE SALE OF THE CORPORATION'S ASSETS OR OPERATIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS; D. THE CORPORATION BECOMING A PARTY TO OR OTHERWISE PARTICIPATING IN A JOINT VENTURE OR PARTNERSHIP WITH ANOTHER ENTITY OR INDIVIDUAL; E. ANY CHANGE IN THE CORPORATION'S MISSION, VISION OR STRATEGIC PLAN; F. DISCONTINUATION, CLOSURE OR TRANSFER OF OWNERSHIP OF SUBSTANTIALLY ALL OF THE ASSETS, OR MEMBERSHIP INTEREST IN, A CORPORATION SITE OF OPERATION; G. APPROVAL OF THE NAMES OR CHANGES TO THE NAMES OF THE CORPORATION'S ENTITIES AND FACILITIES; H. UNLESS CONTEMPLATED BY A PREVIOUSLY APPROVED BUDGET OR PLAN, THE SALE LEASE, TRANSFER, PLEDGE, ENCUMBRANCE, EXCHANGE OR OTHER DISPOSITION OF ASSETS OF THE CORPORATION; I. INCURRENCE OF AN UNBUDGETED DEBT OR UNBUDGETED CAPITAL LEASE OBLIGATION BY THE CORPORATION; AND, J. ADOPTION OF AN ANNUAL OPERATING BUDGET, MODIFICATION OF AN APPROVED ANNUAL OPERATING BUDGET, ADOPTION OF AN ANNUAL CAPITAL BUDGET OR MODIFICATION OF AN APPROVED ANNUAL CAPITAL BUDGET. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR THE EXECUTIVE MANAGEMENT TEAM. AN EXTERNAL ACCOUNTING FIRM REVIEWS AND SIGNS THE RETURN. BEFORE THE RETURN IS FILED, A COMPLETE COPY IS PROVIDED TO THE CURRENT BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS IS MANAGED BY THE CHIEF COMPLIANCE OFFICER (CCO). THE CCO IS RESPONSIBLE FOR ASSURING THAT ALL COMPLETED FORMS ARE RETURNED IN A TIMELY AND COMPLETE MANNER. CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT TO SYSTEM TRUSTEES, MEMBERS OF THE GOVERNING BOARDS FOR SUBSIDIARY ENTITIES, OFFICERS, AND KEY EMPLOYEES FOR ALL ENTITIES SUBJECT TO THE IRS FORM 990 FILINGS. THE DISCLOSURES ARE SUMMARIZED FOR REVIEW BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, PURSUANT TO POLICY. THIS REVIEW ALLOWS: 1) THE BOARD TO ACQUIRE AN AWARENESS OF FINANCIAL RELATIONSHIPS OF BOARD MEMBERS AND KEY MANAGEMENT EMPLOYEES AND CAN INVOKE THE RECUSAL PROCESS ON A CASE-BY-CASE BASIS IF POTENTIAL CONFLICTS ARE IMPLICATED IN BOARD DECISIONS AND DELIBERATIONS, AND, 2) GIVES THE BOARD THE OPPORTUNITY TO SEEK ADDITIONAL INFORMATION AND CLARIFICATION ABOUT DISCLOSURES TO DETERMINE POTENTIAL CONFLICTS OF INTEREST AND HOW TO MANAGE THEM. FORM 990, PART VI, SECTION B, LINE 15 SANFORD HAS A PROCESS FOR DETERMINING COMPENSATION OF THE PERSONS LISTED ON PART VII, SECTION A. THIS INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, REVIEW OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION FOR SUCH COMPENSATION. SANFORD ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO, AND TO REPORT THE FINDINGS TO THEM FOR DELIBERATION AND ACTION. THE DELIBERATIONS AND ACTIONS ARE RECORDED IN THE MINUTES OF THE SANFORD BOARD OF TRUSTEES. THE MOST RECENT STUDY WAS COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH THE ORGANIZATION DOES NOT MAINTAIN A WEBSITE WHERE THE PUBLIC CAN ACCESS THESE DOCUMENTS, IT WOULD RESPOND INDIVIDUALLY TO ANY REQUESTS OR INQUIRIES FROM THE PUBLIC FOR THESE DOCUMENTS. FORM 990, PART VII THE SANFORD BOARD OF TRUSTEES HAS ULTIMATE GOVERNANCE RESPONSIBILITIES FOR EACH MAJOR OPERATING ENTITY WITHIN SANFORD. IN ADDITION, A BOARD OF DIRECTORS IS ESTABLISHED FOR EACH MAJOR OPERATING ENTITY. THIS BOARD HAS SPECIFIC RESPONSIBILITIES DELEGATED FROM THE BOARD OF TRUSTEES. GENERALLY THESE RESPONSIBILITIES ARE RELATED TO THE OVERSIGHT OF THE DAY TO DAY OPERATIONS OF THAT ENTITY. FORM 990, PART XI, LINE 9: REIMBURSEMENT FROM SANFORD HEALTH FOR CASH FLOW INCURRED BY F-M AMBULANCE 508,311. ADAMS COUNTY GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 461495572 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 ARLINGTON GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 371805492 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 BOISE GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 363370371 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 COLLISTER DRIVE HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 300872973 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 GOOD SAMARITAN SOCIETY INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460349951 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271212446 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 LEA COUNTY GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 453946645 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 LILAC WAY GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 465740381 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 MILLARD GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460396332 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 OLATHE GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460396398 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 PRESCOTT GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 275114421 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 PROPHETSTOWN GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460392943 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 RAPID CITY GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 461579750 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 SANFORD P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271218956 SUPPORTING ORGANIZATION ND 501(C)(3) 12-II 0 SANFORD HEALTH FOUNDATION NORTH P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450398104 FOUNDATION ND 501(C)(3) 7 SANFORD NORTH 1 SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 411389317 FOUNDATION MN 501(C)(3) 7 SANFORD HEALTH OF NORTHERN MINNESOTA 1 SANFORD HEALTH FOUNDATION WEST P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450397196 FOUNDATION ND 501(C)(3) 7 SANFORD BISMARCK 1 SIOUX FALLS DOWNTOWN GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 452473519 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 1 THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460422866 FOUNDATION MN 501(C)(3) 12-I SANFORD HEALTH 1 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450228055 LONG-TERM CARE, SENIOR HOUSING & HOME AND COMMUNITY BASED SERVICES ND 501(C)(3) 10 SANFORD 1 ADA COUNTY GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 364799439 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 ADAMS COUNTY GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 383896526 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 COLLISTER DRIVE HOUSING LLC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 611752929 LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD N/A 0 0 HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271212511 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 LILAC WAY GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 364786577 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 MILLARD GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271212324 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 OLATHE GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 205297369 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 PENNINGTON COUNTY GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 384060178 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 PRESCOTT GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 275115281 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 RAPID CITY GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 352466169 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 RUTH STREET GOOD SAMARITAN HOUSING LLC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 611748321 LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD N/A 0 0 SIOUX FALLS DOWNTOWN GOOD SAMARITAN LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 320377442 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 TEXAS GOOD SAMARITAN HOUSING LLC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 371774574 LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD N/A 0 0 GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 815037667 INSURANCE NE N/A C 0 GOOD SAMARITAN SOCIETY INSURANCE LTD P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 980379099 INSURANCE CJ N/A C 0 HERITAGE HEALTHCARE OF NORTHERN NEW MEXICO INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 900491537 PROVIDE HOME AND COMMUNITY BASED SERVICES NM N/A S 0 HERITAGE HEALTHCARE SERVICES INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 850418562 PROVIDE HOME AND COMMUNITY BASED SERVICES NM N/A S 0 HERITAGE HOME HEALTHCARE & HOSPICE INC P O BOX 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SHANGHAI CH HEALTHCARE CH N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 SANFORD HEALTH S 508311 CASH METHOD