STRATEGY STUDIO / PUBLIC DATA EXPLORER

EBENEZER SOCIETY: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
EBENEZER SOCIETY (EIN 41-0706141)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-10-26
IRS object ID
202322999349301517
Schema version
2022v5.0
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)
Return2023-10-26T18:00:16+00:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410706141EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ebenezer SocietyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEBENBusinessNameControlTxt
Phone6128743460PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17505 Metro Boulevard Suite 100AddressLine1Txt
CityEdinaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554393017ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJonathan LundbergPersonNm
Person TitlePresidentPersonTitleTxt
Signature2023-10-26SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJonathanPersonFirstNm
Person LastLundbergPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Jonathan LundbergBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line17505 Metro Boulevard Suite 100AddressLine1Txt
CityEdinaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554393017ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$27,335,084GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.fairview.ebenezer.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1919FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionEbenezer helps older adults and others make their lives more independent, healthful, meaningful and secure. With our partners at Fairview Health Services, we provide access throughout Minnesota to a full range of housing options, community-based programs and services.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee1069TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,227,252PYContributionsGrantsAmt
CY Contributions Grants$1,299,328CYContributionsGrantsAmt
PY Program Service Revenue$12,265,485PYProgramServiceRevenueAmt
CY Program Service Revenue$26,003,452CYProgramServiceRevenueAmt
PY Investment Income$254,917PYInvestmentIncomeAmt
CY Investment Income$32,304CYInvestmentIncomeAmt
PY Other Revenue$11,859,939PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$25,607,593PYTotalRevenueAmt
CY Total Revenue$27,335,084CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,990,421PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,680,753CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,653,505PYOtherExpensesAmt
CY Other Expenses$6,027,392CYOtherExpensesAmt
PY Total Expenses$27,643,926PYTotalExpensesAmt
CY Total Expenses$26,708,145CYTotalExpensesAmt
PY Revenues Less Expenses-$2,036,333PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$626,939CYRevenuesLessExpensesAmt
Total Assets BOY$59,031,436TotalAssetsBOYAmt
Total Assets EOY$61,531,272TotalAssetsEOYAmt
Total Liabilities BOY$34,170,472TotalLiabilitiesBOYAmt
Total Liabilities EOY$37,209,333TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$24,860,964NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$24,321,939NetAssetsOrFundBalancesEOYAmt
MissionEbenezer helps older adults and others make their lives more independent, healthful, meaningful and secure. With our partners at Fairview Health Services, we provide access throughout Minnesota to a full range of housing options, community-based programs and services.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$17,563,304ExpenseAmt
Revenue$26,003,452RevenueAmt
DescEbenezer helps older adults and others make their lives more independent, healthful, meaningful and secure. With our partners at Fairview Health Services, we provide access throughout Minnesota to a full range of housing options, community-based programs and services.Desc
Total Program Service Expenses$17,563,304TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document85IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1069EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Todd WillettBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6128743460PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17505 Metro Boulevard Suite 100AddressLine1Txt
CityEdinaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
James Hereford
Ex-Officio2.040.0Yes (X)Yes (X)$0$3,370,758$116,860
Jonathan Lundberg
President40.02.0Yes (X)Yes (X)$0$543,648$33,171
Richard Howard
Chair, ended 5-20220.31.5Yes (X)Yes (X)$0$0$0
Scott Wordelman
Chair0.31.5Yes (X)Yes (X)$0$0$0
Todd Willett
CFO, Treasurer40.02.0Yes (X)Yes (X)$326,029$0$19,313
Carl Runck
Director0.31.5Yes (X)$0$0$0
Carolyn Jacobson
Director0.31.5Yes (X)$0$0$0
Christina Widdess
Director, new 5-20220.31.5Yes (X)$0$0$0
Kenneth Ashton-Piper
Director, New 5-20220.31.5Yes (X)$0$0$0
Kimberly Faust
Director2.040.0Yes (X)$0$359,093$37,597
Robb Gruman
Director0.31.5Yes (X)$0$0$0
Robert Walker
Director, new 5-20220.31.5Yes (X)$0$0$0
Susan Carlson-Weinberg
Vice Chair0.31.5Yes (X)$0$0$0
Thomas Hokr
Secretary0.31.5Yes (X)$0$0$0
Brenda Johnson
Operations VP40.00.0$179,859$0$8,812Yes (X)
Connie Bednarek
Controller40.00.0$162,738$0$1,747Yes (X)
Douglas Melby
Finance Director40.00.0$201,276$0$7,835Yes (X)
Mark Stauffenecker
Registered Nurse40.00.0$187,773$0$18,238Yes (X)
Robert Britain
Administrator40.00.0$143,835$0$15,128Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,201,510TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,273,499TotReportableCompRltdOrgAmt
Total Other Compensation$258,701TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K41IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtAddress Line2ContractorAddress/USAddress/AddressLine2TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Network Therapy Service LLC
8120 Penn Avenue SouthSuite 480MinneapolisMN55431Rehab Services$1,651,315
Grapetree Medical Staffing LLC
PO Box 5340Sioux FallsSD57117Medical Staffing Services$1,148,407
Annleo INC
PO Box 5341Sioux FallsSD571175341Medical Staffing Services$297,219
Clifton Larson Allen LLP
PO Box 1067St CloudMN563021067Accounting Services$278,754
Bestoption Medical Staffing LLC
8500 Normandale BlvdSuite 350BloomingtonMN55437Medical Staffing Services$202,155
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$115,910RelatedOrganizationsAmt
Government Grants$1,183,418GovernmentGrantsAmt
Total Contributions$1,299,328TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Assisted Living Nursing Services623990$7,144,752$7,144,752
Assisted Living Rent Services531390$6,033,032$6,033,032
Nursing Home Patient Services623000$12,811,838$12,811,838
Cafeteria722320$13,830$13,830

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$26,003,452TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,153TotalRevenueColumnAmt
Exclusion$5,153ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$27,151SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$27,151SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,151TotalRevenueColumnAmt
Exclusion$27,151ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,335,084TotalRevenueColumnAmt
Related Or Exempt Func Income$26,003,452RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$32,304ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$326,029TotalAmt
Management And General$326,029ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$17,834,832TotalAmt
Program Services$12,800,311ProgramServicesAmt
Management And General$5,034,521ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$20,836TotalAmt
Program Services$20,836ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,242,173TotalAmt
Program Services$701,785ProgramServicesAmt
Management And General$540,388ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,256,883TotalAmt
Program Services$850,175ProgramServicesAmt
Management And General$406,708ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$121,817TotalAmt
Program Services$31,685ProgramServicesAmt
Management And General$90,132ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$38,950TotalAmt
Management And General$38,950ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$260,690TotalAmt
Management And General$260,690ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$29,389TotalAmt
Management And General$29,389ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$438,598TotalAmt
Program Services$192,121ProgramServicesAmt
Management And General$246,477ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,479,744TotalAmt
Program Services$1,330,512ProgramServicesAmt
Management And General$149,232ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$38,431TotalAmt
Program Services$8,481ProgramServicesAmt
Management And General$29,950ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$119,821TotalAmt
Program Services$65,125ProgramServicesAmt
Management And General$54,696ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$620,749TotalAmt
Management And General$620,749ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$990,204TotalAmt
Management And General$990,204ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Non-Medical Supplies$870,572$816,608$53,964
Medical Supplies$400,958$399,614$1,344
Licenses/Fees/Memberships$186,545$62,442$124,103
Repairs & Maintenance$185,378$184,987$391

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$245,546TotalAmt
Program Services$98,622ProgramServicesAmt
Management And General$146,924ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,708,145TotalAmt
Program Services$17,563,304ProgramServicesAmt
Management And General$9,144,841ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,378,635BOYAmt
EOY$5,628,742EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,488,402BOYAmt
EOY$3,374,215EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$24,165,669BOYAmt
EOY$27,943,345EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$87,381BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$142,476BOYAmt
EOY$153,461EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$34,918,585LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,817,907LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,717,435BOYAmt
EOY$19,100,678EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,051,176BOYAmt
EOY$909,478EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$483,125BOYAmt
EOY$471,513EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$500,000BOYAmt
EOY$807,395EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,017,137BOYAmt
EOY$3,142,445EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$59,031,436BOYAmt
EOY$61,531,272EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,537,246BOYAmt
EOY$15,355,571EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$138,674BOYAmt
EOY$110,583EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,494,552BOYAmt
EOY$21,743,179EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$34,170,472BOYAmt
EOY$37,209,333EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,860,964BOYAmt
EOY$24,321,939EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,860,964BOYAmt
EOY$24,321,939EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$59,031,436BOYAmt
EOY$61,531,272EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$626,939ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$273,263NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments$32,299PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$925,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$78,362CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$126,036CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$678,054CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,227,252CurrentTaxYearMinus1YearAmt
Current Tax Year$1,299,328CurrentTaxYearAmt
Total$3,409,032TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,287,878CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,456,142CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,303,444CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,125,424CurrentTaxYearMinus1YearAmt
Current Tax Year$26,003,452CurrentTaxYearAmt
Total$107,176,340TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,366,240CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,582,178CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,981,498CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,352,676CurrentTaxYearMinus1YearAmt
Current Tax Year$27,302,780CurrentTaxYearAmt
Total$110,585,372TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$110,585,372PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,545,666CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,564,991CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,158,266CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,765CurrentTaxYearMinus1YearAmt
Current Tax Year$5,153CurrentTaxYearAmt
Total$19,287,841TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,545,666CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,564,991CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,158,266CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,765CurrentTaxYearMinus1YearAmt
Current Tax Year$5,153CurrentTaxYearAmt
Total$19,287,841TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$25,911,906CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$26,147,169CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,139,764CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,366,441CurrentTaxYearMinus1YearAmt
Current Tax Year$27,307,933CurrentTaxYearAmt
Total$129,873,213TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.8515PublicSupportCY509Pct
Public Support PY5090.799PublicSupportPY509Pct
Investment Income CY0.15InvestmentIncomeCYPct
Investment Income PY0.201InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$644,666OtherCostOrOtherBasisAmt
Book Value$644,666BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,974,602OtherCostOrOtherBasisAmt
Depreciation$12,226,862DepreciationAmt
Book Value$17,747,740BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,174,007OtherCostOrOtherBasisAmt
Depreciation$2,687,310DepreciationAmt
Book Value$486,697BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,125,310OtherCostOrOtherBasisAmt
Depreciation$903,735DepreciationAmt
Book Value$221,575BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$19,100,678TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Operating Leases$1,960,112
Debt Service Fund
Restricted Fund Invest$1,182,333
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,142,445TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
LT Debt$19,292,360
Other LT Debt - Operating Leases$2,105,887
LT Debt - Current$344,932
FieldValueIRS element (for citing)
Total Liability$21,743,179TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part IV, Line 2b Explanation of escrow agreementEbenezer Society holds in trust deposit amounts received by tenants upon move-in. The tenant deposits are maintained in an interest-bearing account separate from Ebenezer Society's accounts. Deposits are refunded, minus any amounts for repairs, when the tenant leaves the facility.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteTHE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Todd Willett
CFO, Treasurer$308,273$0$0$0$17,756$0$0$0$19,313$0$345,342$0$0$0
Jonathan Lundberg
President$0$363,251$0$139,389$0$41,008$0$18,580$0$14,591$0$576,819$0$38,485
James Hereford
Ex-Officio$0$1,753,793$0$1,399,311$0$217,654$0$100,535$0$16,325$0$3,487,618$0$208,150
Kimberly Faust
Director$0$318,422$0$39,244$0$1,427$0$18,300$0$19,297$0$396,690$0$0
Mark Stauffenecker
Registered Nurse$165,611$0$21,500$0$662$0$5,801$0$12,437$0$206,011$0$0$0
Douglas Melby
Finance Director$188,404$0$2,000$0$10,872$0$0$0$7,835$0$209,111$0$0$0
Brenda Johnson
Operations VP$179,339$0$0$0$520$0$0$0$8,812$0$188,671$0$0$0
Connie Bednarek
Controller$152,131$0$2,000$0$8,607$0$0$0$1,747$0$164,485$0$0$0
Robert Britain
Administrator$135,625$0$6,600$0$1,610$0$7,250$0$7,878$0$158,963$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planThe following individuals participated in a nonqualified retirement plan: James Hereford, Jonathan Lundberg Due to a vesting event, the following individuals had income in Part VII and Schedule J related to a nonqualified retirement plan: James Hereford $208,150 Jonathan Lundberg $38,485
Schedule J, Part I, Line 7 Non-fixed paymentsFAIRVIEW HEAL TH SERVICES PROVIDES LUMP SUM FINANCIAL AWARDS BASED ON SYSTEM-WIDE, BUSINESS UNIT AND/OR DEPARTMENTS FINANCIAL AND QUALITY MEASURES. ANNUAL GOALS, SPECIFICALLY TIED TO PRODUCTIVITY AND QUALITY INDICATORS, ARE SET FOR THE YEAR AND AN INCENTIVE PAID OUT ANNUALLY IF KEY GOALS AND MEASURES ARE ACHIEVED.
Schedule J, Part I, Line 3 Related Org to establish compensationTHE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.
Schedule J, Part III Other Additional InformationThe nonqualified plan is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. The contribution is unfunded. The plan complies with section 457(f) of the Code.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 3b Form 990-T Not Filed ExplanationThere was no unrelated income reported in the current tax year, therefore no Form 990T is required to be filed.
Form 990, Part VI, Line 6 Classes of members or stockholdersTHE MEMBERS OF THIS CORPORATION SHALL CONSIST SOLELY AND EXCLUSIVELY OF THE PERSONS WHO CONSTITUTE THE DIRECTORS OF THIS CORPORATION FROM TIME TO TIME. WHEN A PERSON BECOMES A DIRECTOR OF THIS CORPORATION, SUCH PERSON SHALL CONCURRENTLY WITH BECOMING SUCH A DIRECTOR, AUTOMATICALLY BECOME AND BE A MEMBER OF THIS CORPORATION, AND WHEN A PERSON CEASES TO BE A DIRECTOR OF THIS CORPORATION, THEY SHALL CONCURRENTLY WITH CEASING TO BE SUCH A DIRECTOR, AUTOMATICALLY CEASE TO BE A MEMBER OF THIS CORPORATION.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE CHAIR OF THE CORPORATION SHALL BE ELECTED FROM AND BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SHALL ELECT MEMBERS TO DIRECTOR POSITIONS AND FILL VACANCIES IN ELECTED DIRECTOR POSITIONS. THE BOARD OF DIRECTORS OF THIS CORPORATION SHALL ELECT MEMBERS FROM THE NOMINEES MADE FROM THE BOARDS OF EACH OF THE CONSTITUENT ORGANIZATIONS AS LISTED IN THE BYLAWS OF THIS CORPORATION.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersHE FOLLOWING ACTIONS MUST BE APPROVED BY FAIRVIEW HEALTH SERVICES, THE SOLE CORPORATE MEMBER: (A) ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS; (B) ALL CAPITAL BUDGETS OF THE ORGANIZATION AND ALL OTHER ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS ORGANIZATION, AND ALL MAJOR CAPITAL EXPENDITURES BEFORE FUNDS ARE EXPENDED THEREFOR; (C) ALL OPERATING BUDGETS OF THIS ORGANIZATION AND ALL OTHER ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS ORGANIZATION, BEFORE AUTHORIZED EXPENDITURES MAY BE MADE THEREFROM; (D) STRATEGIC PLANS OF THIS ORGANIZATION AND ALL OTHER ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS ORGANIZATION; (E) THE INCURRING OF ANY LONG TERM DEBT OF THIS ORGANIZATION AND ALL OTHER ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS ORGANIZATION, OTHER THAN INTRA-SYSTEM OF REFINANCING DEBT; (F) ALL HUMAN RESOURCES AND BENEFIT POLICIES;(G) ANY MAJOR RISK CONTRACTING AGREEMENTS, WHICH FOR THESE PURPOSES MEANS ANY CONTRACT THAT DEALS WITH CAPITATION OR A SIMILAR RISK BEARING CONCEPT; (H) ANY MERGER, CONSOLIDATION, OR TOTAL OR PARTIAL DISSOLUTION; (I) THE NUMBER OF DIRECTORS; AND (J) ANY GOVERNANCE AND ACTION OF THE TYPE SET FORTH IN SUBPARAGRAPHS (A) AND (F) THROUGH (I) ABOVE AS PROPOSED BY THE BOARD OF DIRECTORS OF ANY ENTITY DIRECTLY CONTROLLED BY THIS ORGANIZATION TO THE EXTENT THAT THE GOVERNING DOCUMENTS OF SUCH ENTITY GIVE THIS ORGANIZATION OR THE BOARD A RIGHT TO APPROVAL OVER SUCH GOVERNANCE ACTION.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyTHE TAX DEPARTMENT CONDUCTS A DETAILED REVIEW OF THE COMPLETED RETURN. THE RETURN IS ALSO REVIEWED BY THE PRESIDENT AND CFO. THE FORM 990 IS SUBSEQUENTLY PRESENTED TO THE BOARD OF DIRECTORS. UPON APPROVAL FROM THE BOARD OF DIRECTORS, THE FORM 990 IS FILED.
Form 990, Part VI, Line 12c Conflict of interest policyMANAGERS, DIRECTORS AND SENIOR MANAGEMENT ARE REQUIRED TO ANNUALLY COMPLETE A DUTY OF LOYALTY AND CONFLICT OF INTEREST STATEMENT IN COMPLIANCE WITH FAIRVIEW'S SYSTEM CONFLICT OF INTEREST POLICY. DISCLOSURES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. ANY CONFLICTS OF INTEREST BY BOARD MEMBERS ARE BROUGHT TO THE BOARD FOR REVIEW.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialTHE DETERMINATION OF EXECUTIVE COMPENSATION OF THE ORGANIZATION IS PROCESSED BY YHE FAIRVIEW SYSTEM HUMAN RESOURCES COMMITTEE AND INCLUDES A REVIEW OF COMPARABILITY DATA, REVIEW BY INDEPENDENT EXPERTS AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION PROCESS.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesTHE DETERMINATION OF EXECUTIVE COMPENSATION OF THE ORGANIZATION IS PROCESSED BY THE FAIRVIEW SYSTEM HUMAN RESOURCES COMMITTEE AND INCLUDES A REVIEW OF COMPARABILITY DATA, REVIEW BY INDEPENDENT EXPERTS AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION PROCESS.
Form 990, Part VI, Line 19 Required documents available to the publicEBENEZER SOCIETY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND INSPECTION OF THE DOCUMENTS IS AVAILABLE AT THE CORPORATE FINANCE DEPARTMENT.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesDistribution to related party - -925000;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Ebenezer York Assisted Living LLC
7505 Metro Boulevard Suite 100EdinaMN55439262912486HousingMN$6,089,282$13,323,548Ebenezer Society
Fairview Woods LLC
7505 Metro Boulevard Suite 100EdinaMN55439204381407HousingMN$5,495,384$7,333,240Ebenezer Society
Ebenezer Towers on Portland LLC
7505 Metro Boulevard Suite 100EdinaMN55439472019262HousingMN$30,747$2,283,072Ebenezer Society
Edina Senior Living LLC
6500 France Avenue SouthEdinaMN55435472449637HousingMN$2,746,231$15,097,473Ebenezer Society

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Fairview Health Services
2450 Riverside AvenueMinneapolisMN55454410991680HospitalMN501(c)(3)3nafalse
Ebenezer Ridges Assisted Living
7505 Metro Boulevard Suite 100EdinaMN55439411964691AssistedMN501(c)(3)10Ebenezer SocietyYes (true)
Ebenezer Ridges
7505 Metro Boulevard Suite 100EdinaMN55439411287792NursingMN501(c)(3)10Ebenezer SocietyYes (true)
Ebenezer Society Foundation
7505 Metro Boulevard Suite 100EdinaMN55439411356565SupportMN501(c)(3)Type IEbenezer SocietyYes (true)
Ebenezer Ridge Point Apartments
7505 Metro Boulevard Suite 100EdinaMN55439411769727HousingMN501(c)(3)10Ebenezer SocietyYes (true)
Ebenezer Towers
7505 Metro Boulevard Suite 100EdinaMN55439237005359HousingMN501(c)(3)10Ebenezer SocietyYes (true)
Ebenezer Lakes Senior Housing
7505 Metro Boulevard Suite 100EdinaMN55439320190409HousingMN501(c)(3)10Ebenezer SocietyYes (true)
Ebenezer Lakes Assisted Living
7505 Metro Boulevard Suite 100EdinaMN55439412012560AssistedMN501(c)(3)10Ebenezer SocietyYes (true)
Fairview Home Care and Hospice
2450 Riverside AveMinneapolisMN55454411434246Home Health CareMN501(c)(3)10Fairview Health Servicesfalse
Fairview Physician Associates Network
7505 Metro Blvd Suite 100EdinaMN55439411753325SpecialtyMN501(c)(3)10Fairview Health Servicesfalse
Fairview Foundation
2450 Riverside AveMinneapolisMN55454411573810FoundationMN501(c)(3)7Fairview Health Servicesfalse
Range Regional Health Care
750 East 34th StreetHibbingMN55746411293970HospitalMN501(c)(3)3Fairview Health Servicesfalse
Grand Itasca Clinic and Hospital
1601 Golf Course RoadGrand RapidsMN55744411865874HospitalMN501(c)(3)3Fairview Health Servicesfalse
PreferredOne Community Health Plan
2450 Riverside AveMinneapolisMN55454411796007INSURANCEMN501(c)(4)Fairview Health Servicesfalse
Fairview Bethesda Hospital
2450 Riverside AveMinneapolisMN55454363517697HospitalMN501(c)(3)3Fairview Health Servicesfalse
HealthEast St Joseph's Hospital
2450 Riverside AveMinneapolisMN55455410693880HospitalMN501(c)(3)3Fairview Health Servicesfalse
HealthEast St John's Hospital
2450 Riverside AveMinneapolisMN55454411456897HospitalMN501(c)(3)3Fairview Health Servicesfalse
HealthEast Woodwinds Hospital
2450 Riverside AveMinneapolisMN55454411592761HospitalMN501(c)(3)3Fairview Health Servicesfalse
HealthEast Professional Services
2450 Riverside AveMinneapolisMN55454261226617Medical ServicesMN501(c)(3)7Fairview Health Servicesfalse
HealthEast Medical Research Institute
2450 Riverside AveMinneapolisMN55454411765832Meical ResearchMN501(c)(3)4Fairview Health Servicesfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtAddress Line2USAddress/AddressLine2Txt
Ridges Surgery Center LLC
14101 Fairview Drive Suite 400BurnsvilleMN55337462441825Surgery CenterMNFairview Health ServciesN/A
Southhealth ASC LLC
4200 Dahlberg DriveGolden ValleyDE55422822364607Surgery CenterMNFairview Health ServicesN/ASuite 300

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
Ebenezer Management Services Inc
7505 Metro Boulevard Suite 100EdinaMN55439411567046Mgmt SvcsMNEbenezer SocietyC Corporation$22,867,363$35,320,3361Yes (true)
Ebenezer Development Inc
7505 Metro Blvd Suite 100EdinaMN55439883201659Property ManagementMNEbenezer SocietyC Corporation$0$1,046,1721Yes (true)
Fairview Clinics
2450 Riverside AveMinneapolisMN55454411761760Medical ServicesMNFairview Health ServicesC Corporationfalse
Fairview Express Care
2450 Riverside AveMinneapolisMN55454205996177Medical ServicesMNFairview Health ServicesC Corporationfalse
Fairview Development Company
2450 Riverside AveMinneapolisMN55454411568579LeaseholdMNFairview Health ServicesC Corporationfalse
Fairview Physician and Clinic Services
2450 Riverside AveMinneapolisMN55454411544996Medical ServicesMNFairview Health ServicesC Corporationfalse
HealthEast Diversified Services Inc
2450 Riverside AveMinneapolisMN55454411388583Lab & Real EstateMNFairview Health ServicesC Corporationfalse
FHS Assurance LTD
2450 Riverside AveMinneapolisMN55454980417513Self InsuranceMNFairview Health ServicesC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Ebenezer Society Foundation
O$232,444Cost
Ebenezer Lakes Assisted Living
O$4,053,291Cost
Ebenezer Lakes Senior Housing
O$64,272Cost
Ebenezer Ridge Point Apartments
O$111,353Cost
Ebenezer Ridges Assisted Living
O$2,339,272Cost
Ebenezer Ridges
O$12,936,268Cost
Ebenezer Management Services
Q$3,182,289Cost
Ebenezer Ridges
Q$211,798Cost
Ebenezer Society Foundation
C$115,910Cost