F-M AMBULANCE SERVICE INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- F-M AMBULANCE SERVICE INC (EIN 45-0344371)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-10-31
- IRS object ID
- 202313049349302166
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-10-31T15:27:38-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 155 N WACKER DRIVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450344371 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | F-M AMBULANCE SERVICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | F-MA | BusinessNameControlTxt |
| Phone | 7012342000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5039 RTE 5218 | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571175039 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BILL MARLETTE | PersonNm |
| Person Title | EVP, CFO & TREASURER | PersonTitleTxt |
| Phone | 6053331000 | PhoneNum |
| Signature | 2023-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BILL | PersonFirstNm |
| Person Last | MARLETTE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESS WAGENER | PreparerPersonNm |
| PTIN | P01622613 | PTIN |
| Phone | 3128792000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BILL GASSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2301 EAST 60TH ST | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,819,831 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.FMAMBULANCE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | "DEDICATED TO THE WORK OF HEALTH AND HEALING" | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $221,483 | PYContributionsGrantsAmt |
| CY Contributions Grants | $355,853 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,436,733 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,404,157 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $41,226 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,094 | PYOtherRevenueAmt |
| CY Other Revenue | $13,978 | CYOtherRevenueAmt |
| PY Total Revenue | $18,663,310 | PYTotalRevenueAmt |
| CY Total Revenue | $18,815,214 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,845,284 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,412,945 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,167,470 | PYOtherExpensesAmt |
| CY Other Expenses | $4,896,679 | CYOtherExpensesAmt |
| PY Total Expenses | $15,012,754 | PYTotalExpensesAmt |
| CY Total Expenses | $17,309,624 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,650,556 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,505,590 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,709,124 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,237,188 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $176,397 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $65,783 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,532,727 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,171,405 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,493,680 | ExpenseAmt |
| Revenue | $18,404,157 | RevenueAmt |
| Desc | 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. | Desc |
| Total Program Service Expenses | $15,493,680 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BILL MARLETTE EVP CFO & TREASURER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6053331000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2301 EAST 60TH STREET | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| BRYAN NERMOE | |||||||||
| PRESIDENT & CEO, FARGO-END 3/22 | 5.00 | 55.00 | Yes (X) | $0 | $457,274 | $37,952 | |||
| BRYAN NERMOE | |||||||||
| SEE SCH J, PART III, LINES 4A-4B | 5.00 | 55.00 | Yes (X) | $0 | $2,719,941 | $0 | |||
| BILL GASSEN III | |||||||||
| TRUSTEE, PRESIDENT & CEO | 0.50 | 59.50 | $0 | $2,683,582 | $379,583 | Yes (X) | Yes (X) | ||
| MICHELLE BRUHN | |||||||||
| EVP, CFO & TREASURER | 0.50 | 59.50 | $0 | $1,530,538 | $186,998 | Yes (X) | |||
| MARIA BELL MD | |||||||||
| TRUSTEE, PHYSICIAN | 0.50 | 59.50 | $0 | $1,143,694 | $43,942 | Yes (X) | |||
| TIFFANY LAWRENCE | |||||||||
| PRESIDENT & CEO, FARGO-BEG 3/22 | 5.00 | 55.00 | Yes (X) | $0 | $924,767 | $132,767 | |||
| MARK LUNDEEN MD | |||||||||
| TRUSTEE, PHYSICIAN | 0.50 | 59.50 | $0 | $343,914 | $13,962 | Yes (X) | |||
| JOANN KUNKEL | |||||||||
| FORMER CFO-SCH J, PART III, LINE 4A | 0.00 | 0.00 | $0 | $339,000 | $0 | Yes (X) | |||
| ANDY NORTH | |||||||||
| TRUSTEE, SECRETARY | 0.50 | 6.61 | $0 | $316,771 | $0 | Yes (X) | Yes (X) | ||
| MARK PAULSON MD | |||||||||
| TRUSTEE, PHYSICIAN | 0.50 | 59.50 | $0 | $239,394 | $38,669 | Yes (X) | |||
| NEIL GULSVIG | |||||||||
| TRUSTEE, CHAIRPERSON | 0.50 | 6.61 | $0 | $75,772 | $0 | Yes (X) | Yes (X) | ||
| LAURIS MOLBERT | |||||||||
| TRUSTEE, VICE CHAIR | 0.50 | 6.61 | $0 | $35,500 | $0 | Yes (X) | Yes (X) | ||
| MARNIE HERMANN | |||||||||
| TRUSTEE | 0.50 | 6.61 | $0 | $35,500 | $0 | Yes (X) | |||
| DON JACOBS | |||||||||
| TRUSTEE | 0.50 | 6.61 | $0 | $34,500 | $0 | Yes (X) | |||
| JAMES CAIN | |||||||||
| TRUSTEE | 0.50 | 6.61 | $0 | $34,500 | $0 | Yes (X) | |||
| ROBIN SMITH | |||||||||
| TRUSTEE, TREASURER | 0.50 | 6.61 | $0 | $34,000 | $0 | Yes (X) | Yes (X) | ||
| WESLEY ENGBRECHT | |||||||||
| TRUSTEE | 0.50 | 6.61 | $0 | $34,000 | $0 | Yes (X) | |||
| BRENT TEIKEN | |||||||||
| TRUSTEE, PAST CHAIR | 0.50 | 6.61 | $0 | $33,000 | $0 | Yes (X) | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $11,015,647 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $833,873 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,065 | RelatedOrganizationsAmt |
| Government Grants | $352,788 | GovernmentGrantsAmt |
| Total Contributions | $355,853 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMERGENCY MEDICAL SERV | 621910 | $16,960,451 | $16,960,451 |
| EDUCATION | 611430 | $1,244,154 | $1,244,154 |
| CONTRACT/OUTREACH | 624230 | $184,293 | $184,293 |
| SPECIAL TRANSPORTATION | 621910 | $15,259 | $15,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,404,157 | TotalProgramServiceRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $45,600 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,374 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $41,226 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,226 | TotalRevenueColumnAmt |
| Exclusion | $41,226 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $14,221 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $243 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,978 | TotalRevenueColumnAmt |
| Exclusion | $13,978 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,815,214 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,404,157 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $55,204 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,175,628 | TotalAmt |
| Program Services | $9,318,652 | ProgramServicesAmt |
| Management And General | $856,976 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,939 | TotalAmt |
| Program Services | $458,921 | ProgramServicesAmt |
| Management And General | $25,018 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $978,753 | TotalAmt |
| Program Services | $873,219 | ProgramServicesAmt |
| Management And General | $105,534 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $774,625 | TotalAmt |
| Program Services | $738,401 | ProgramServicesAmt |
| Management And General | $36,224 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,702 | TotalAmt |
| Management And General | $3,702 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $783,918 | TotalAmt |
| Program Services | $732,337 | ProgramServicesAmt |
| Management And General | $51,581 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,711 | TotalAmt |
| Program Services | $57,275 | ProgramServicesAmt |
| Management And General | $9,436 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,613 | TotalAmt |
| Program Services | $186,325 | ProgramServicesAmt |
| Management And General | $43,288 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,877 | TotalAmt |
| Program Services | $240,000 | ProgramServicesAmt |
| Management And General | $162,877 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,908 | TotalAmt |
| Program Services | $220,598 | ProgramServicesAmt |
| Management And General | $110,310 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,444 | TotalAmt |
| Program Services | $414,770 | ProgramServicesAmt |
| Management And General | $12,674 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,270 | TotalAmt |
| Program Services | $245,148 | ProgramServicesAmt |
| Management And General | $5,122 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $863,230 | TotalAmt |
| Program Services | $817,536 | ProgramServicesAmt |
| Management And General | $45,694 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,690 | TotalAmt |
| Program Services | $1,660 | ProgramServicesAmt |
| Management And General | $287,030 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,089,168 | $1,079,410 | $9,758 |
| CERTIFICATES, LIC, DUES | $56,970 | $22,349 | $34,621 |
| MINNESOTACARE TAX | $48,911 | $48,911 | |
| BOOKS & SUBSCRIPTIONS | $17,651 | $17,454 | $197 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,616 | TotalAmt |
| Program Services | $20,714 | ProgramServicesAmt |
| Management And General | $15,902 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,309,624 | TotalAmt |
| Program Services | $15,493,680 | ProgramServicesAmt |
| Management And General | $1,815,944 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250 | BOYAmt |
| EOY | $250 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,481,111 | BOYAmt |
| EOY | $2,388,787 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,218 | BOYAmt |
| EOY | $5,975 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249 | BOYAmt |
| EOY | $16,997 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,395,752 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,680,864 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,430,906 | BOYAmt |
| EOY | $3,714,888 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,393,082 | BOYAmt |
| EOY | $1,393,082 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,308 | BOYAmt |
| EOY | $717,209 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,709,124 | BOYAmt |
| EOY | $8,237,188 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,397 | BOYAmt |
| EOY | $65,783 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,397 | BOYAmt |
| EOY | $65,783 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,532,727 | BOYAmt |
| EOY | $8,171,405 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,532,727 | BOYAmt |
| EOY | $8,171,405 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,709,124 | BOYAmt |
| EOY | $8,237,188 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,505,590 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $133,088 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $410,810 | OtherCostOrOtherBasisAmt |
| Book Value | $410,810 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,358,545 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,445,259 | DepreciationAmt |
| Book Value | $913,286 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $169,295 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,751 | DepreciationAmt |
| Book Value | $124,544 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,308,815 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,064,933 | DepreciationAmt |
| Book Value | $2,243,882 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $148,287 | OtherCostOrOtherBasisAmt |
| Depreciation | $125,921 | DepreciationAmt |
| Book Value | $22,366 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,714,888 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER ASSETS-CIP | Desc |
| Book Value | $717,209 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $717,209 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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, 2022; SOME RELATED ORGANIZATIONS HAVE ESTABLISHED RESERVES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN NERMOE | ||||||||||||||
| PRESIDENT & CEO, FARGO-END 3/22 | $0 | $175,719 | $0 | $252,724 | $0 | $28,831 | $0 | $30,585 | $0 | $7,367 | $0 | $495,226 | $0 | $0 |
| BRYAN NERMOE | ||||||||||||||
| SEE SCH J, PART III, LINES 4A-4B | $0 | $0 | $0 | $0 | $0 | $2,719,941 | $0 | $0 | $0 | $0 | $0 | $2,719,941 | $0 | $688,398 |
| BILL GASSEN III | ||||||||||||||
| TRUSTEE, PRESIDENT & CEO | $0 | $1,818,239 | $0 | $582,757 | $0 | $282,586 | $0 | $378,828 | $0 | $755 | $0 | $3,063,165 | $0 | $0 |
| MICHELLE BRUHN | ||||||||||||||
| EVP, CFO & TREASURER | $0 | $1,012,253 | $0 | $350,000 | $0 | $168,285 | $0 | $160,681 | $0 | $26,317 | $0 | $1,717,536 | $0 | $0 |
| MARIA BELL MD | ||||||||||||||
| TRUSTEE, PHYSICIAN | $0 | $1,020,094 | $0 | $54,000 | $0 | $69,600 | $0 | $15,250 | $0 | $28,692 | $0 | $1,187,636 | $0 | $0 |
| TIFFANY LAWRENCE | ||||||||||||||
| PRESIDENT & CEO, FARGO-BEG 3/22 | $0 | $729,385 | $0 | $68,796 | $0 | $126,586 | $0 | $105,250 | $0 | $27,517 | $0 | $1,057,534 | $0 | $0 |
| MARK LUNDEEN MD | ||||||||||||||
| TRUSTEE, PHYSICIAN | $0 | $332,590 | $0 | $0 | $0 | $11,324 | $0 | $11,832 | $0 | $2,130 | $0 | $357,876 | $0 | $0 |
| JOANN KUNKEL | ||||||||||||||
| FORMER CFO-SCH J, PART III, LINE 4A | $0 | $0 | $0 | $0 | $0 | $339,000 | $0 | $0 | $0 | $0 | $0 | $339,000 | $0 | $0 |
| ANDY NORTH | ||||||||||||||
| TRUSTEE, SECRETARY | $0 | $316,771 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $316,771 | $0 | $0 |
| MARK PAULSON MD | ||||||||||||||
| TRUSTEE, PHYSICIAN | $0 | $221,637 | $0 | $13,500 | $0 | $4,257 | $0 | $10,612 | $0 | $28,057 | $0 | $278,063 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | CERTAIN ITEMS LISTED ON LINE 1A ARE PROVIDED BY RELATED ORGANIZATIONS. PART I, LINE 3: THE EXECUTIVE COMPENSATION COMMITTEE OF THE SANFORD BOARD OF TRUSTEES DIRECTLY 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 2022. |
| 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: BRYAN NERMOE: SEPARATION.......................................$2,011,302 NONQUALIFIED RETIREMENT PLAN........................$708,639 TOTAL............................................$2,719,941 JOANN KUNKEL: NON-COMPETE PAYMENT.................................$339,000 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | SA-F OPENED A NEW AMBULANCE STATION IN WEST FARGO IN SEPTEMBER OF 2022 TO ACCOMMODATE THE GROWTH OF THE CITY TO THE WEST AND SOUTH. FUTURE AMBULANCE STATIONS WILL BE ADDED IN SOUTH MOORHEAD AND SOUTH FARGO IN THE COMING YEARS. |
| 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: MARIA BELL, MARK LUNDEEN, MARK PAULSON, BRYAN NERMOE, MICHELLE BRUHN, 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 NORTH. |
| FORM 990, PART VI, SECTION A, LINE 7B | SANFORD NORTH MUST APPROVE THE FOLLOWING ACTIONS: * MODIFYING THE PURPOSE OF THE CORPORATION * UNBUDGETED CAPITAL EXPENSES IN EXCESS OF 1/2 OF 1% OF APPROVED OPERATING BUDGETS *ADOPTION OF CAPITAL AND OPERATING BUDGETS *ACQUISITION, SALE, LEASE, DISPOSITION, OR MORTGAGING OF REAL PROPERTY *GUARANTEE OF DEBTS OR OBLIGATIONS OF ANY OTHER PERSON, FIRM, CORPORATION, PARTNERSHIP, ASSOCIATION, OR OTHER ENTITY WHICH IF HELD IN DEFAULT WOULD OBLIGATE THE CORPORATION TO AN AGGREGATE AMOUNT IN EXCESS OF $100,000 *MERGER OR CONSOLIDATION OF THE CORPORATION *INCURRING A LOAN OR OTHER OBLIGATION IN AN AGREEMENT IN EXCESS OF $500,000 FOR MORE THAN 60 DAYS *MAKING OF A GIFT, GRANT OR OTHER DONATION IN AN AMOUNT IN EXCESS OF $5,000 TO AN ORGANIZATION NOT RELATED TO THE CORPORATION OR MEMBER *MEMBER HAS THE AUTHORITY TO DIRECT THE CORPORATION REGARDLESS OF THE VOTE BY THE CORPORATION'S BOARD OF DIRECTORS TO TRANSFER ASSETS AND/OR FUNDS TO THE HEALTH SYSTEM TO SATISFY OBLIGATIONS OF THE HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. AN EXTERNAL ACCOUNTING FIRM REVIEWS THE RETURN. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR THE BOARD OF TRUSTEES MEETING PRIOR TO THE RETURN FILING DATE. 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 | A RELATED PARTY, SANFORD HEALTH, DOES HAVE A PROCESS FOR DETERMINING COMPENSATION OF THE PERSONS LISTED ON PART VII SECTION A, INCLUDING A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, REVIEW OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION FOR SUCH COMPENSATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE SANFORD BOARD OF TRUSTEES DIRECTLY 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 2022. |
| 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 OPERATION 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 THE FOUNDATION 133,088. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (1) |
| HOWARD LAKE GOOD SAMARITAN HOUSING INC | ||||||||||
| P O BOX 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 364885253 | PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS | SD | 501(C)(3) | 10 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (1) |
| SANFORD HEALTH FOUNDATION WEST | ||||||||||
| P O BOX 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 450397196 | FOUNDATION | ND | 501(C)(3) | 7 | SANFORD BISMARCK | Yes (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 | Yes (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 | Yes (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 | Yes (1) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
| NATIONAL STUDENT HOUSING-SOUTH DAKOTA LLC | |||||||||
| 100 S PHILLIPS AVE | SIOUX FALLS | SD | 57104 | 202129839 | INVESTMENT | 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 |
| RAC RENTALS LLC | |||||||||
| 100 S PHILLIPS AVE | SIOUX FALLS | SD | 57104 | 261961077 | INVESTMENT | 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 INSURANCE PLAN OF NORTH DAKOTA | |||||||||||||
| P O BOX 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 815020633 | INSURANCE | ND | N/A | C | 0 | ||||
| GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA INC | |||||||||||||
| P O BOX 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 814989242 | INSURANCE | SD | N/A | C | 0 | ||||
| GOOD SAMARITAN SOCIETY INSURANCE LTD | |||||||||||||
| P O BOX 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 980379099 | INSURANCE | N/A | C | 0 | CJ | ||||
| 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 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 850463468 | PROVIDE HOME AND COMMUNITY BASED SERVICES | NM | N/A | S | 0 | ||||
| HERITAGE HOME HEALTHCARE OF ARIZONA INC | |||||||||||||
| P O BOX 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 204243949 | PROVIDE HOME AND COMMUNITY BASED SERVICES | NM | N/A | S | 0 | ||||
| HERITAGE HOME HEALTHCARE SERVICES INC | |||||||||||||
| P O BOX 5039 RTE 5218 | SIOUX FALLS | SD | 571175039 | 850463469 | PROVIDE HOME AND COMMUNITY BASED SERVICES | NM | N/A | S | 0 | ||||
| SANFORD FRONTIERS | |||||||||||||
| 1305 W 18TH STREET PO BOX 5039 | SIOUX FALLS | SD | 571175039 | 455436599 | WEIGHT LOSS/FITNESS | SD | N/A | C | 0 | ||||
| SANFORD HEALTH PLAN | |||||||||||||
| 300 CHERAPA PLACE | SIOUX FALLS | SD | 57103 | 911842494 | INSURANCE | SD | N/A | C | 0 | ||||
| SANFORD HEALTH PLAN OF MN | |||||||||||||
| 300 CHERAPA PLACE | SIOUX FALLS | SD | 57103 | 460445852 | INSURANCE | MN | N/A | C | 0 | ||||
| SANFORD INTERNATIONAL - MUNICH GMBH | |||||||||||||
| HEALTHCARE | N/A | C | 0 | GM | NYMPHENBURGER STRASSE 3 | MUNICH | GM | ||||||
| SANFORD WORLD CLINICS - GHANA | |||||||||||||
| HEALTHCARE | N/A | C | 0 | GH | SARBAH ROAD TANTRI LORRY STATION | CAPE COAST | GH | ||||||
| SHANGHAI SANFORD HEALTHCARE MANAGEMENT CONSULTING CO LTD | |||||||||||||
| HEALTHCARE | N/A | C | 0 | CH | 188 YESHENG ROAD ROOM A-862 GUOMA | SHANGHAI | CH | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SANFORD HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | S | TransactionTypeTxt |
| Involved | $133,088 | InvolvedAmt |
| Method Of Amount Determination | CASH METHOD | MethodOfAmountDeterminationTxt |